TY - JOUR
T1 - Supine blood pressure—A clinically relevant determinant of vascular target organ damage in hypertensive patients
AU - Nolde, Janis M.
AU - Kiuchi, Márcio Galindo
AU - Carnagarin, Revathy
AU - Frost, Shaun
AU - Kannenkeril, Dennis
AU - Lugo-Gavidia, Leslie Marisol
AU - Chan, Justine
AU - Joyson, Anu
AU - Matthews, Vance B.
AU - Herat, Lakshini Y.
AU - Azzam, Omar
AU - Schlaich, Markus P.
PY - 2021/1
Y1 - 2021/1
N2 - Night-time blood pressure (BP) is an important predictor of cardiovascular outcomes. Its assessment, however, remains challenging due to limited accessibility to ambulatory BP devices in many settings, costs, and other factors. We hypothesized that BP measured in a supine position during daytime may perform similarly to night-time BP when modeling their association with vascular hypertension-mediated organ damage (HMOD). Data from 165 hypertensive patients were used who as part of their routine clinic workup had a series of standardized BP measurements including seated attended office, seated and supine unattended office, and ambulatory BP monitoring. HMOD was determined by assessment of kidney function and pulse wave velocity. Correlation analysis was carried out, and univariate and multivariate models were fitted to assess the extent of shared variance between the BP modalities and their individual and shared contribution to HMOD variables. Of all standard non-24-hour systolic BP assessments, supine systolic BP shared the highest degree of variance with systolic night-time BP. In univariate analysis, both systolic supine and night-time BP were strong determinants of HMOD variables. In multivariate models, supine BP outperformed night-time BP as the most significant determinant of HMOD. These findings indicate that supine BP may not only be a clinically useful surrogate for night-time BP when ambulatory BP monitoring is not available, but also highlights the possibility that unattended supine BP may be more closely related to HMOD than other BP measurement modalities, a proposition that requires further investigations in prospective studies.
AB - Night-time blood pressure (BP) is an important predictor of cardiovascular outcomes. Its assessment, however, remains challenging due to limited accessibility to ambulatory BP devices in many settings, costs, and other factors. We hypothesized that BP measured in a supine position during daytime may perform similarly to night-time BP when modeling their association with vascular hypertension-mediated organ damage (HMOD). Data from 165 hypertensive patients were used who as part of their routine clinic workup had a series of standardized BP measurements including seated attended office, seated and supine unattended office, and ambulatory BP monitoring. HMOD was determined by assessment of kidney function and pulse wave velocity. Correlation analysis was carried out, and univariate and multivariate models were fitted to assess the extent of shared variance between the BP modalities and their individual and shared contribution to HMOD variables. Of all standard non-24-hour systolic BP assessments, supine systolic BP shared the highest degree of variance with systolic night-time BP. In univariate analysis, both systolic supine and night-time BP were strong determinants of HMOD variables. In multivariate models, supine BP outperformed night-time BP as the most significant determinant of HMOD. These findings indicate that supine BP may not only be a clinically useful surrogate for night-time BP when ambulatory BP monitoring is not available, but also highlights the possibility that unattended supine BP may be more closely related to HMOD than other BP measurement modalities, a proposition that requires further investigations in prospective studies.
KW - hypertension-mediated organ damage
KW - kidney function
KW - nocturnal blood pressure
KW - pulse wave velocity
KW - supine blood pressure
UR - http://www.scopus.com/inward/record.url?scp=85097023945&partnerID=8YFLogxK
U2 - 10.1111/jch.14114
DO - 10.1111/jch.14114
M3 - Article
C2 - 33270963
AN - SCOPUS:85097023945
SN - 1524-6175
VL - 23
SP - 44
EP - 52
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 1
ER -