Night-time home versus ambulatory blood pressure in determining target organ damage. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Andreadis, Emmanuel A.; Agaliotis, Gerasimos; Kollias, Anastasios; Kolyvas, George; Achimastos, Apostolos; Stergiou, George S.
• Is Part Of: Journal of hypertension. Volume 34:Issue 3(2016:Mar.)
• Publication Date: 2016-03
• Subjects: home blood pressure -- nocturnal blood pressure -- self-measurement -- target organ damage; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000000815
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: This study aimed to evaluate the association of night-time blood pressure (BP) assessed by home blood pressure (HBP) or ambulatory blood pressure (ABP) monitoring with preclinical target organ damage in untreated hypertension. Methods: Untreated hypertensive study participants were evaluated with ABP monitoring (24-h) and HBP monitoring during daytime (6 days, duplicate morning and evening measurements) and night-time (automated asleep measurements, three nights, 3-hourly measurements/night). Target organ damage was assessed by echocardiographic left ventricular mass index (LVMI), common carotid intima–media thickness (cIMT), urine albumin excretion (UAE), and ankle-brachial index (ABI). Results: A total of 131 study participants were analysed [mean age 52.1 ± 11.9 (SD) years, BMI 29.9 ± 5.3 kg/m 2, men 58%, cardiovascular disease history 6.1%]. Daytime and night-time HBP were slightly higher than the respective ABP values (mean difference for systolic daytime/night-time 3.5 ± 10.6/2.6 ± 9.8 mmHg, P < 0.01 for both comparisons and diastolic −0.3 ± 6.8/1.2 ± 6.2 mmHg, P = NS/0.02, respectively). There was a strong correlation between daytime ABP and HBP ( r = 0.71/0.72, systolic/diastolic), as well as between the respective night-time values ( r = 0.80/0.79; all P < 0.01). Night-time ABP and HBP presented strong and comparable correlations with all the indices of preclinical target organ damage. In multivariate analyses, both LVMI ( R 2 = 0.26) and cIMT ( R 2 = 0.25) were determined by night-time systolic HBP, age and male sex; UAE ( R 2 = 0.28) by night-time systolic HBP and male sex; ABI ( R 2 = 0.20) by male sex and night-time home pulse pressure. Conclusion: In untreated hypertensives, night-time BP assessed by home monitoring appears to be as good as night-time ambulatory monitoring in determining preclinical target organ damage.