Blood Pressure Variability As Well As Blood Pressure Level is Important for Left Ventricular Hypertrophy and Brachial-Ankle Pulse Wave Velocity in Hypertensives

Abstract

Blood pressure (BP) variability is calculated as the standard deviation of ambulatory BP. Blood pressure variability is associated with the cardiovascular morbidity; however whether it is related to target organ damage is controversial. In this study we examined a possible relationship between the BP variability and left ventricular hypertrophy (LVH), and between BP variability and brachial-ankle pulse wave velocity (baPWV). The present study was conducted on 111 consecutive Japanese hypertensive patients who were hospitalized for the educational program in our hospital under stable sodium chloride intake (6 g/day). Blood pressure measurements were at 30-minute intervals all day. In a multivariable analysis adjusted with confounding factor, LVH was associated with 24-hour systolic BP (SBP), 24 hour diastolic BP (DBP), daytime SBP, daytime DBP, nighttime SBP, and nighttime DBP. Additionally, nighttime DBP variability was related to LVH. By the same method, baPWV as a dependent variable was related to 24-hour SBP and nighttime SBP. Furthermore, nighttime SBP variability was concerned with baPWV. The LVH was associated with not only BP level but also with nighttime DBP variability. The baPWV was also related not only to BP level but also to nighttime SBP variability.

Association Between Long-Term Blood Pressure Variability and 10-Year Progression in Arterial Stiffness

“…Another study by Ichihara et al 41 showed that a one SD higher 24-h ambulatory systolic BP was associated with an increase in baPWV by 38.7 mm/sec (95% CI: 3.4, 73.9) among 203 newly diagnosed and untreated hypertensive patients after adjusting for confounders. Ozawa et al 42 also found that independent of other risk factors, baPWV was lower by 0.23 cm/sec ( P =0.03) for a SD higher nighttime systolic BP among 92 hospitalized Japanese hypertensive patients.…”

Questionable link between normo- to microalbuminuria and home-measured blood pressure variability in hypertension

“…5,6 Short-term BP variability has also been suggested to be clinically relevant because hypertensive patients with similar mean 24 h BP values exhibit more severe organ damage when their short-term BP variability is greater. [7][8][9][10][11][12][13][14] With respect to home-measured BP, several clinical studies (both long-term followup surveys and cross-sectional studies) have provided an epidemiological basis for supporting the greater accuracy of home BP monitoring than clinic BP measurement for the prognosis of fatal and nonfatal cardiovascular disease (CVD). There is a general consensus that home BP monitoring is more convenient, more readily available and less costly than ambulatory BP monitoring, but ambulatory BP monitoring has been recognized to be superior for certain clinical problems, for example, for the detection of non-dippers or sleep BP in patients with chronic renal disease, autonomic neuropathies or sleep apnea, and for the estimation of short-term BP variability.…”

Serum soluble RAGE level inversely correlates with left ventricular hypertrophy in essential hypertension patients

“…Hypertensive LVH is a multi-factor pathological process, and identifying the key determinants involved is critically important for developing strategies to prevent heart failure. Acknowledged LVH risk factors include blood pressure, duration of hypertension, age, obesity, diet, and pharmacologic treatment (Schirmer et al, 1999;Ozawa et al, 2009).…”