Office blood pressure is a predictor of aortic elastic properties and urinary protein excretion in subjects with white coat hypertension

Aznaouridis, Konstantinos; Vlachopoulos, Charalambos; Masoura, Konstantina; Pietri, P.; Vyssoulis, Gregory P.; Ioakeimidis, N.; Stefanadis, Christodoulos; Tousoulis, Dimitrios

doi:10.1016/j.ijcard.2015.10.078

Cited by 11 publications

(13 citation statements)

References 27 publications

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“…Urine α 1 ‐microglobulin has been previously significantly correlated with office SBP (but not DBP) in hypertensive patients . Recently, it has been closely associated with office SBP (but not DBP) in patients with white‐coat hypertension as well . Moreover, significant correlations have been reported between urine α 1 ‐microglobulin and 24‐hour SBP variability, after adjustment for age, sex, and smoking …”

Section: Discussionmentioning

confidence: 97%

Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Liakos

Vyssoulis

Markou

et al. 2016

J of Clinical Hypertension

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2The purpose of this study was to assess the role of urine a 1 -microglobulin as a marker of hypertension-induced renal damage compared with estimated glomerular filtration rate, (eGFR), urine albumin, and urine albumin-to-creatinine ratio (ACR). Its response on different blood pressure (BP)-lowering drugs was also studied. Sixty never-treated hypertensive patients (65.0% men, 46.9 years, BP 141.4/94.0 mm Hg) were randomized to an irbesartan (an angiotensin receptor blocker [ARB]) or a diltiazem (a nondihydropyridine calcium channel blocker [CCB])-based regimen. Patients with diabetes or established cardiovascular, renal, or liver disease were excluded. Blood samples and 24-hour urine were analyzed at baseline and 6 months after pharmaceutical BP normalization. Serum creatinine was measured and eGFR was calculated. Urine albumin, creatinine, and a 1 -microglobulin were measured and ACR was calculated. Minor changes (P=not significant [NS]) in eGFR were noted during follow-up in both groups (from 111.0 mL/min/1.73 m 2 to 108.4 mL/min/1.73 m 2 in the ARB group and from 111.3 mL/min/1.73 m 2 to 114.0 mL/min/1.73 m 2 in the CCB group). Twenty-four-hour urine indices were all significantly improved (P<.01) in the ARB group (albumin from 19.4 mg/L to 8.2 mg/L, ACR from 21.5 mg/g to 10.0 mg/g, a 1 -microglobulin from 5.06 mg/L to 3.64 mg/L) but not (P=NS) in the CCB group (albumin from 15.6 mg/L to 13.9 mg/L, ACR from 17.6 mg/g to 17.1 mg/g, a 1 -microglobulin from 4.94 mg/L to 4.79 mg/L). These differences between groups remained significant (P<.05) after adjusting for office heart rate and BP. a 1 -Microglobulin was significantly correlated (P<.05) with albumin and ACR both at baseline (r=0.283 and 0.299, respectively) and at the end of follow-up (r=0.432 and 0.465, respectively) but not (P=NS) with eGFR. It was also significantly related (P<.05) to cardiovascular risk scores (Framingham and HeartScore) both at baseline (r=0.264 and 0.436, respectively) and at the end of follow-up (r=0.308 and 0.472, respectively). Urine a 1 -microglobulin emerges as a potentially usable marker of hypertension-induced renal impairment. Its excretion rate and its response to treatment appears similar to that of albumin. Irbesartan but not diltiazem seems to be associated with reduced excretion of a 1 -microglobulin in urine.

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Section: Discussionmentioning

confidence: 97%

Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Liakos

Vyssoulis

Markou

et al. 2016

J of Clinical Hypertension

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“…It can be argued that only a measure of BP above the stipulated cutoff would not have clinical significance, but many studies are proving that pressure-ability cannot be called physiological, and these oscillatory levels of blood pressure represent damage to target organs [12, 13]. It is interesting to note that the widening of the pulse pressure, considered one of the indicators of vascular rigidity [14], did not show different odds in the two groups studied.…”

Section: Discussionmentioning

confidence: 99%

Probability of At Least One High Arterial Blood Pressure Measurement in Elderly Patients with Healthy Vascular Aging in Two Years of Follow-Up

Freitas

Souza

Ferreira-Filho

2018

Kidney Blood Press Res

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Background/Aims: Elderly patients with normal systemic arterial blood pressure associated with femoral carotid pulse velocity (cf-PWV) less than 7.6 m/s and without associated comorbidities are considered to have good vascular health. The aim of the current study was to verify the probability that elderly patients with good vascular health have at least one blood pressure measurement above the different thresholds for systolic blood pressure (120, 130 and 140 mmHg) during two years of follow–up. Methods: We selected 72 normotensive patients (< 140/90 mmHg) without comorbidities and divided them into group A, with cf-PWV < 7.6 m/s (n = 27; 65 ± 4 years), and group B, with cf-PWV ≥ 7.6 m/s (n = 45; 66± 8 years). These patients were followed for two years and were observed in 3 outpatient visits (0, 12 and 24 months). At each visit, the brachial pressures were indirectly measured in triplicate, and applanation tonometry was performed. Results: When group A and group B were compared, the odds ratio (OR) of having a systolic pressure measurement ≥ 140 mmHg in two years of follow-up was 0.22 (P < 0.0001); ≥ 130 mmHg, the OR was 0.49 (P < 0.0007), and ≥ 120 mmHg, the OR was 0.54 (P < 0.001). Group A and group B showed increased values of cf-PWV during the two years of follow-up (P < 0.05). Changes in the average systolic brachial pressure were not significant during the two years in groups A or B. Conclusion: Vascular health in elderly individuals seems to protect against occasional elevations in systemic arterial pressure.

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“…In our study, we found that IOUH was independently associated with arterial stiffness, assessed through PWV. Although some studies have shown a similar association, they were conducted in untreated populations . Aznaouridis and colleagues found office systolic BP to be an independent predictor of aortic elastic properties, as opposed to ambulatory BP, in a study conducted in nondiabetic untreated individuals with WCH.…”

Section: Discussionmentioning

confidence: 95%

“…Although in untreated persons WCH has been related to target organ damage, including arterial stiffness, data in treated patients with IOUH are scarce. The purpose of the present study was to determine a possible association between IOUH and arterial stiffness in treated hypertensive patients.…”

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confidence: 99%

Arterial Stiffness in Treated Hypertensive Patients With White‐Coat Hypertension

Barochiner

Aparicio

Alfie

et al. 2016

J of Clinical Hypertension

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Arterial stiffness, assessed through pulse wave velocity (PWV), independently predicts cardiovascular outcomes. In untreated persons, white‐coat hypertension (WCH) has been related to arterial stiffness, but data in treated patients with WCH are scarce. The authors aimed to determine a possible association between WCH and arterial stiffness in this population. Adult treated hypertensive patients underwent home blood pressure monitoring and PWV assessment. Variables associated with PWV in univariable analyses were entered into a multivariable linear regression model. The study included 121 patients, 33.9% men, median age 67.9 (interquartile range 18.4) years, 5.8% with diabetes, and 3.3% with a history of cardiovascular or cerebrovascular disease. In multivariable analysis, WCH in treated hypertensive patients remained a determinant of PWV: β=1.1 (95% confidence interval, 0.1–2.1 [P=.037]; adjusted R2 0.49). In conclusion, WCH is independently associated with arterial stiffness in treated hypertensive patients. Whether this high‐risk association is offset by antihypertensive treatment should be further investigated.

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Office blood pressure is a predictor of aortic elastic properties and urinary protein excretion in subjects with white coat hypertension

Cited by 11 publications

References 27 publications

Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Probability of At Least One High Arterial Blood Pressure Measurement in Elderly Patients with Healthy Vascular Aging in Two Years of Follow-Up

Arterial Stiffness in Treated Hypertensive Patients With White‐Coat Hypertension

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Office blood pressure is a predictor of aortic elastic properties and urinary protein excretion in subjects with white coat hypertension

Cited by 11 publications

References 27 publications

Twenty‐Four–Hour Urine α1‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Twenty‐Four–Hour Urine α1‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Probability of At Least One High Arterial Blood Pressure Measurement in Elderly Patients with Healthy Vascular Aging in Two Years of Follow-Up

Arterial Stiffness in Treated Hypertensive Patients With White‐Coat Hypertension

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Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs

Twenty‐Four–Hour Urine α₁‐Microglobulin as a Marker of Hypertension‐Induced Renal Impairment and Its Response on Different Blood Pressure–Lowering Drugs