22. BP Variability as Well as Mean BP from Ambulatory Blood Pressure and Home Blood Pressure Correlates Well with Target Organ Damage in Untreated Hypertensive Patients

Abstract

Background

We sought to assess the relation of ambulatory blood pressure(ABP) measurement and home blood pressure(HBP) measurement with target organ damage using BP variability(BPV) as well as mean BP in untreated hypertensive patients.

Methods

Seventy-nine untreated patients with hypertension(men : 52 and female : 27 , mean age, 47.5 ± 13.1years) underwent measurements of ABP, HBP and OBP. The ABP was recorded for 24hrs, HBP was measured for 1week, and OBP was measured at least in two visits. All BP measurements were taken using automatic BP measuring device. The parameters indicating target organ damage were the left-ventricular mass index(LVMI) by transthoracic echocardiography, urinary albumin excretion rate(AER), carotid-femoral pulse-wave velocity(PWV), and carotid intima-media thickness(IMT).

Results

The LVMI was significantly correlated with systolic HBP, systolic/diastolic 24hrs ABP, and systolic ABP variability(ABPV), but was not correlated with OBP. The AER, PWV and IMT were significantly correlated with systolic HBP. In a binary logistic regression analysis, systolic HBP was only predictor of LVMI(p = 0.003) and systolic HBP, systolic 24hrs ABP and systolic HBPV were significant predictors of PWV(HBP; p = 0.001, ABP; p = 0.027, HBPV; p = 0.036). Also, systolic HBP was independent predictor of AER and PWV by multiple regression analysis(AER; p = 0.004, PWV; p = 0.009).

Conclusion

Our data suggest that ABP and HBP measurements are closely related to hypertension-induced target organ damage as assessed by LVMI, AER and PWV. Therefore, ABP and HBP measurements using BP variability as well as mean BP may give additive information for the prediction of cardiovascular target organ damage in hypertension.