Association of the magnitude of the difference in blood pressure between office and ambulatory measurements with blood pressure variability in untreated individuals

Clinical Hypertension

Research

Byong-Kyu Kim¹  Ungjeong Do²  Ji-Hyun Kim²  Je Sang Kim²  Moo-Yong Rhee³  Hae-Young Kim⁴  Yea Je Lee⁵ 

[1] Cardiology Division, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea;Cardiovascular Center, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong -gu, 10326, Goyang-si, Goyang, Gyeonggi-do, Korea;Cardiovascular Center, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong -gu, 10326, Goyang-si, Goyang, Gyeonggi-do, Korea;College of Medicine, Dongguk University, 123 Dongdae-ro, 38066, Gyeongju-si, Gyeongsangbuk-do, Republic of Korea;Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea;Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea;

关键词: Blood pressure;    Hypertension;    Masked effect;    Risk;   

DOI  :  10.1186/s40885-022-00220-7

 received in 2022-03-30, accepted in 2022-07-19,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectivesWe evaluated the association between cardiovascular risk factors and the magnitude of the difference in systolic blood pressure (SBP) between office and ambulatory measurements (masked effect) in untreated individuals without apparent hypertension-mediated organ damage (HMOD).MethodsThe inclusion criteria were 1) age ≥ 20 years, 2) blood pressure ≥ 140/90 mmHg at the outpatient clinic, and 3) not receiving antihypertensive medications. The difference between office and ambulatory SBP was calculated by subtracting the ambulatory daytime SBP from the office SBP. The association between the masked effect and SBP variability was analyzed in individuals without HMOD (no electrocardiographic left ventricular hypertrophy, spot urine albumin-to-creatinine ratio < 30 mg/g, and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2, n = 296).ResultsAmong the cardiovascular risk factors, ambulatory BP variability was significantly correlated with the SBP difference. The standard deviation (SD) and coefficient of variation (cv) of 24-h SBP exhibited a significant negative linear association with the SBP difference in univariate and multivariate analyses adjusted for age, sex, presence of diabetes, and 24-h ambulatory SBP. A significant association was observed in patients with ambulatory daytime hypertension. In the multivariate analysis, individuals with a negative SBP difference > -5 mmHg exhibited a higher SD and cv of 24-h SBP than those with a negative SBP difference ≤ -5 mmHg or a positive SBP difference.ConclusionsThe results of our study suggest that the magnitude of the negative difference in office and ambulatory SBP may be a potential risk factor, even in individuals without apparent HMOD.Trial registrationThis trial is registered with ClinicalTrials.gov (NCT03855605).

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 4