Ambulatory Blood Pressure Phenotypes and the Risk for Hypertension

Viera, Anthony J.; Shimbo, Daichi

doi:10.1007/s11906-014-0481-5

Cited by 21 publications

(19 citation statements)

References 28 publications

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“…Thus, it allows the recognition of individual risk profile of patients. It can be helpful in identifying patients at increased risk of developing sustained hypertension and cardiovascular events [11]. Also, elevated BP variability during ABPM is associated with increased risk of cardiovascular events, cerebral and renal damage [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Erdogmus¹,

Kutlay²,

Celebi³

et al. 2018

Kidney Blood Press Res

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Background/Aims: Hypertension and its complications are major public health issues worldwide due to their association with high cardiovascular morbidity and mortality. Despite significant progress in health, the prevalence of hypertension is increasing. Ambulatory blood pressure monitoring (ABPM) is becoming increasingly important for the management of hypertension. In this study, we aimed to investigate the clinical and laboratory correlates of ambulatory blood pressure (ABP) phenotypes at a tertiary care hospital in Turkey. Methods: The characteristics of 1053 patients were retrospectively obtained from the hospital database. Hypertension was defined as patients with office blood pressure (BP) ≥140/90 mmHg and/or previously diagnosed hypertension and/or the use of antihypertensive medication. According to the office BP and ABPM results patients were identified namely: (1) sustained normotensive (SNT) patients (both office BP and ABPM were normal), (2) sustained hypertensive (SHT) patients (both office BP and ABPM were high), (3) masked hypertensive (MHT) patients (office BP were normal, but ABPM were high), (4) white coat hypertensive (WCHT) patients (office BP were above limits, but ABPM were normal). Results: A total of 1053 patients were included to the study (female/male: 608/445 and mean age 55 ± 15 years). The mean age of patients with hypertension was significantly higher than without hypertension (p< 0.0001). Hypertension was more frequent in females (p=0.009). The rates of history of diabetes mellitus (DM), hyperlipidemia (HL), and chronic kidney disease (CKD) were higher in patients with hypertension (p< 0.0001). Among patients with hypertension (n=853, 81%), ABPM results showed that 388 (45%) of patients had SHT, 92 (11%) had MHT, and 144 (17%) had WCHT, whereas 229 (27%) had SNT. Patients with MHT were significantly older than patients with SNT (p=0.025). The prevalence of SHT was higher in men than in women, whereas the prevalence of WCHT was higher in women than in men (p< 0.0001). There was no significant difference between 4 groups with regard to body mass index (p=0.142), a history of DM (p=0.189) and smoking status (self-reported) (p=0.306). Patients with SHT had the highest prevalence of history of hypertension, HL and CKD (p< 0.0001). Among patients without hypertension, 26 (13%) of patients had MHT and none of those patients was on antihypertensive treatment. Conclusion: Potential usages of ABPM in Turkey may include screening of high risk individuals who have traditional cardiovascular risk factors. It also provides clinicians valuable information on abnormal ABP phenotypes. Future studies are needed to clarify the risk factors of different ABP phenotypes and to evaluate the role of ABPM on detection and control of hypertension.

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Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Erdogmus¹,

Kutlay²,

Celebi³

et al. 2018

Kidney Blood Press Res

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“…To test this hypothesis, we compared the prevalence of nocturnal hypertension and nondipping BP in a cohort of black patients with vs without aTRH. Additionally, prior studies have reported that nocturnal hypertension and nondipping BP are associated with an increased risk for developing hypertension based on BP measurements obtained in the clinic . However, few data are available on whether nocturnal hypertension and nondipping BP are associated with developing more difficult to control BP.…”

Section: Introductionmentioning

confidence: 99%

The association of nocturnal hypertension and nondipping blood pressure with treatment‐resistant hypertension: The Jackson Heart Study

Irvin

Booth

Sims

et al. 2018

J of Clinical Hypertension

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Apparent treatment‐resistant hypertension (aTRH), nocturnal hypertension, and nondipping blood pressure (BP) have shared risk factors. The authors studied the association between aTRH and nocturnal hypertension and aTRH and nondipping BP among 524 black Jackson Heart Study participants treated for hypertension. Nocturnal hypertension was defined by mean nighttime systolic BP ≥120 mm Hg or diastolic BP ≥70 mm Hg. Nondipping BP was defined by mean nighttime to daytime systolic BP ratio >0.90. aTRH was defined by mean clinic systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg with three medication classes or treatment with four or more classes. The risk for developing aTRH associated with nondipping BP and nocturnal hypertension was estimated. After multivariable adjustment, participants with aTRH were more likely to have nocturnal hypertension (prevalence ratio, 1.20; 95% confidence interval, 1.03–1.39) and nondipping (prevalence ratio, 1.25; 95% confidence interval, 1.09–1.43). Over a median 7.3 years of follow‐up, nocturnal hypertension and nondipping BP at baseline were not associated with developing aTRH after adjustment.

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“…[1]. Later BP phenotype was understood as clinic (office) and ambulatory measurements ratio [2]. Four BP phenotypes are distinguished: normotension, white coat hypertension (WCH), masked hypertension and sustained hypertension.…”

Section: Blood Pressure Phenotypes фенотипы артериального давленияmentioning

confidence: 99%

“…[1]. Позже под фенотипом АД стали понимать преимуществен-но соотношение показателей клинического (офисного) и ам-булаторного измерений [2]. Выделяют 4 фенотипа АД: нор-мотония, гипертония белого халата (ГБХ), скрытая АГ и устой-чивая АГ.…”

Section: Blood Pressure Phenotypes фенотипы артериального давленияunclassified

Blood Pressure Phenotypes in Treated Hypertensive Patients in Summer and Winter: Focus on Masked Uncontrolled Hypertension. Part 1: Blood Pressure Phenotypes Prevalence

Смирнова

Горбунов

Boytsov

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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Background. The seasonal variability of blood pressure (BP) and cardiovascular morbidity and mortality motivates researchers to search for the new approaches of the antihypertensive treatment (AHT) efficacy assessment, including the analysis of interrelation between clinic and ambulatory BP, i.e. BP phenotypes. Aim. To evaluate the prevalence of BP phenotypes in treated hypertensive outpatients both in winter and summer. Material and methods. Hypertensive patients under regular AHT with available data of clinic BP and 24-hour BP monitoring both in winter and summer seasons (n=477) were selected from a outpatient database with clinic BP <160/100 mm Hg (n=1762). The BP threshold values from current guidelines were used for the BP phenotypes definition. The "controlled hypertension" phenotype was detected when clinic and ambulatory BP levels were less than threshold values, the "uncontrolled hypertension" -when both levels exceeded the thresholds, the "white coat hypertension (WCH) in treated patients" -when clinic BP was only increased, the "masked uncontrolled hypertension" phenotype was ascertained if ambulatory BP was only elevated. Results. The study included 232 patients examined in Ivanovo (a relatively cold region; mean age 53.5±9.3 years; 28% men; clinic BP 121.7±7.9 mm Hg; mean duration of hypertension 4.6±6.3 years) and 245 patients from Saratov (a relatively hot region; mean age 58.3±10.6 years; 56.3% men; clinic BP 127.5±14.9 mmHg; mean duration of hypertension 9.2±9.2 years; р<0.0001). In the Ivanovo cohort, ratio of BP phenotypes in summer and winter did not differ; the "masked uncontrolled hypertension" phenotype prevailed (62.1% and 63.8% in winter and summer, respectively); AHT was effective in 27.6% and 29.7% of the patients in winter and summer, respectively. The prevalence of other phenotypes was low: uncontrolled hypertension -9.5% in winter and 6.0% in summer; WCH in treated patients -less than 1% in both seasons. The prevalence of BP phenotypes in the patients examined in Saratov differed in winter and summer (χ 2 =18.127, р<0.0001); the "masked uncontrolled hypertension" phenotype rate was higher in summer than in winter (50.2% and 32.2%, respectively); the rates of other phenotypes were higher in winter: uncontrolled hypertension -38.8% and 27.8%, controlled hypertension -25.3% and 20.8%, WCH -3.7% and 1.2% in winter and summer, respectively. Conclusion. We have found no seasonal changes in BP phenotypes prevalence in relatively younger hypertensive patients in a relatively cold region. The "masked uncontrolled hypertension" phenotype was predominant (>60%) in this region. In contrast, the cohort of relatively older patients with longer hypertension history examined in a relatively warmer region revealed significantly higher rate of masked uncontrolled hypertension in summer (50.2%) while prevalence of all other phenotypes -in winter.

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Ambulatory Blood Pressure Phenotypes and the Risk for Hypertension

Cited by 21 publications

References 28 publications

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

The association of nocturnal hypertension and nondipping blood pressure with treatment‐resistant hypertension: The Jackson Heart Study

Blood Pressure Phenotypes in Treated Hypertensive Patients in Summer and Winter: Focus on Masked Uncontrolled Hypertension. Part 1: Blood Pressure Phenotypes Prevalence

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