Hypertension‐mediated organ damage regression associates with blood pressure variability improvement three years after successful treatment initiation in essential hypertension

Triantafyllidi, Helen; Benas, D; Schoinas, Antonios; Birmpa, Dionyssia; Trivilou, Paraskevi; Varytimiadi, Efthimia; Voutsinos, D.; Ikonomidis, Ignatios

doi:10.1111/jch.14209

Cited by 14 publications

(16 citation statements)

References 39 publications

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“…However, little is known about the associations between longitudinally assessed differences in BPV and the changes in HDMO. The paper of Triantafyllidi et al 10 published in the current issue of the Journal adds a new piece of evidence in this scenario, showing that the short‐term BPV reduction (Delta BPV) obtained after 3 years of successful antihypertensive therapy was related to a decrease in left ventricular mass (Delta LVMI), independently of the baseline average BPs and other potential confounding factors. 10 This was true only in the subgroup (n = 119) of well‐controlled hypertensive subjects belonging to an overall population of 180 newly diagnosed and never‐treated hypertensive patients.…”

Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 97%

“… 10 This was true only in the subgroup (n = 119) of well‐controlled hypertensive subjects belonging to an overall population of 180 newly diagnosed and never‐treated hypertensive patients. 10 …”

Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 97%

“…However, the study of Triantafyllidi et al 10 needs to be interpreted in the context of its limitations.…”

Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 99%

“… 1 , 2 Far from being a “background noise” that hinders the assessment of “true BP,” 2 short‐term BP variability (BPV) seems to be relevant to the pathophysiology of target organ damage and to the incidence of clinical events. 1 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

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Should reduction of increased short‐term blood pressure variability be a target of antihypertensive therapy?

Mulè

Sorce

Vario

et al. 2021

J of Clinical Hypertension

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An extensive and highly consistent body of evidence indicates that the average level of 24-h ambulatory blood pressure (BP) correlates more closely than casual BP with the cardiovascular (CV) and renal complications of arterial hypertension. 1,2 However, average pressures neglect the temporal variation in BP, which may be also prognostically relevant. 1,[3][4][5][6][7] Since the pioneering observations ofStephen Hales, during the 18th century, BP has been recognized as a fluctuating parameter 2 ; indeed, it has been shown to be characterized by marked spontaneous oscillations over short-term (minutes to hours) and long-term (days to months) periods. Important BP variations from summer to winter have also been consistently reported (seasonal BP variability). Although in physiological conditions these variations may represent an adaptive humoral and neural response to environmental, behavioral, and emotional stimuli occurring in daily life, they may also reflect alterations in CV regulatory mechanisms. 1 Historically, variability in BP has been viewed as a factor inhibiting accurate measurement of mean BP and as a phenomenon to be overcome by improved monitoring. 1,2 Far from being a "background noise" that hinders the assessment of "true BP," 2 short-term BP variability (BPV) seems to be relevant to the pathophysiology of target organ damage and to the incidence of clinical events. 1,3-10 | IND I CE S OF S HORT-TERM B LOOD PRE SSURE VARIAB ILIT YAlthough the precise quantification of short-term BPV requires beat-to-beat BP recording, its assessment is also possible, even if less accurately, through the use of intermittent noninvasive 24hour ambulatory BP monitoring (ABPM), at intervals from 15 to 20 minutes. 1 This allows the straightforward estimation of shortterm BPV by calculating the 24-h BP standard deviation (SD) and the coefficient of variation (SD X 100/BP mean), which accounts for the dependence of the SD on mean BP levels. 1 Despite the

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Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 97%

Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 97%

“…However, the study of Triantafyllidi et al 10 needs to be interpreted in the context of its limitations.…”

Section: Short‐term Blood Pressure Variability and Subclinical Organ Damagementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Should reduction of increased short‐term blood pressure variability be a target of antihypertensive therapy?

Mulè

Sorce

Vario

et al. 2021

J of Clinical Hypertension

View full text Add to dashboard Cite

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“…Analyzing the factors related to sepsis organ function injury can provide more clinical prevention and sepsis-related organ function injury targets and better predict patients' prognosis. Studies have shown that blood pressure variability (BPV) is related to organ function injury in various diseases, but relevant studies focus mainly on patients with cardiovascular diseases (1)(2)(3). The common pathophysiological basis of functional injury of related organs caused by sepsis is that patients cannot maintain blood pressure and withstand the attack of many inflammatory factors.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of blood pressure variability for organ dysfunction in patients with sepsis

Zhu

Cai

et al. 2021

Ann Palliat Med

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Background: Sepsis is a common disease in the intensive care unit, accompanied by many complications and high mortality. Organ dysfunction is a major risk factor for death in patients with sepsis. Analyzing the related factors of organ dysfunction caused by sepsis can provide more clinical prevention and treatment targets, and better predict patients' prognoses. This study aimed to investigate the relationship between blood pressure variability (BPV) and organ dysfunction in patients with sepsis. Methods: One hundred and two patients with sepsis treated in our hospital from January 2019 to January 2021 were retrospectively collected as an observation group, and 102 healthy people were collected as a control group. The 24-hour systolic blood pressure variability (24h SBPV) and 24-hour diastolic blood pressure variability (24h DBPV) of the two groups were compared, and the correlation between 24h SBPV, 24h DBPV, and organ function damage to sepsis patients were analyzed. Results: Compared with the control group, the 24h DBPV in the observation group was significantly higher (0.56±0.16 vs. 0.37±0.16, P=0.000). 24h SBPV increased significantly (0.56±0.16 vs. 0.36±0.17, P=0.000). Pearson linear correlation analysis showed 24h SBPV was positively correlated with the level of procalcitonin, APACHEII score, and SOFA score (r=0.301, 0.216 and 0.218, P<0.05). 24h DBPV was positively correlated with the level of procalcitonin, APACHEII score, and SOFA score (r=0.302, 0.212 and 0.210, P<0.05). 24h SBPV and 24h DBPV are of certain value in the diagnosis of multiple organ failure in patients with sepsis, and the area under the curve was [0.649 (95% CI: 0.539-0.759), P=0.010] and [0.650 (0.540-0.760), P=0.009], respectively. 24h SBPV and 24h DBPV are of certain value in the diagnosis of persistent organ failure in patients with sepsis, and the area under the curve was [0.647 (95% CI: 0.538-0.757), P=0.010] and [0.647 (95% CI: 0.538-0.757), P=0.010], respectively. Conclusions:The increase of BPV in patients with sepsis has a certain value in predicting the prognosis and organ function damage to patients with sepsis.

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Association of blood pressure variability with target organ damage in older patients with essential hypertension

Zhang

Wang

et al. 2023

Chronic Diseases and Translational Medicine

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BackgroundAlthough multiple measures of blood pressure variability (BPV) have been proposed, whether they are better than mean blood pressure in predicting target organs is unclear. We aimed to determine the relationship between short term BPV and target organ injury.MethodsThis study was a retrospective study, and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected. We divided participants into four groups on the basis of the quartiles of BPV. One‐way analysis of variance was used to compare the differences between the groups, and linear regression was used to analyze the relationship between BPV and target organ damage.ResultsThe average age of 635 patients was 74.36 ± 6.50 years old. Among them, 354 of 627 patients had diminished renal function (56.5%), 221of 604 patients had associated left ventricular hypertrophy (36.6%), and 227 of 231 patients had carotid plaque formation (98.3%). The baseline data indicated significant differences in fasting glucose, total cholesterol, low‐density lipoprotein, creatinine, glomerular filtration rate, sex, calcium channel blocker use, and the rate of diminished renal function. Multiple linear regression analysis showed that BPV was negatively correlated with renal injury (creatinine: r = 0.306, p < 0.01; estimated glomerular filtration rate: r = 0.058, p < 0.01), and BPV is positively correlated with cardiac injury (r = 0.083, p < 0.01). Elevated BPV was not found to be associated with vascular injury.ConclusionRenal function decreases with increasing BPV and left ventricular mass increases with increasing BPV.

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Hypertension‐mediated organ damage regression associates with blood pressure variability improvement three years after successful treatment initiation in essential hypertension

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 14 publications

References 39 publications

Should reduction of increased short‐term blood pressure variability be a target of antihypertensive therapy?

Should reduction of increased short‐term blood pressure variability be a target of antihypertensive therapy?

Predictive value of blood pressure variability for organ dysfunction in patients with sepsis

Association of blood pressure variability with target organ damage in older patients with essential hypertension

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