1. Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: the VASOTENS Registry
- Author
-
Elena A Grigoricheva, Irina E. Minyukhina, Ioan Tilea, João Maldonado, Giuseppe Mulè, Telmo Pereira, Vitaliy S. Barkan, Gabriel Waisman, Natalia Bulanova, Gianfranco Parati, Iana Orlova, Anna Paini, Carlos G Ramos-Becerra, Stefano Omboni, M. Derevyanchenko, Isabella Tan, Ayana Arystan, Igor N Posokhov, Omboni, Stefano, Posokhov, Igor, Parati, Gianfranco, Arystan, Ayana, Tan, Isabella, Barkan, Vitaliy, Bulanova, Natalia, Derevyanchenko, Maria, Grigoricheva, Elena, Minyukhina, Irina, Mulè, Giuseppe, Orlova, Iana, Paini, Anna, Peixoto Maldonado, João M, Pereira, Telmo, Ramos-Becerra, Carlos G, Tilea, Ioan, and Waisman, Gabriel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Settore MED/09 - Medicina Interna ,Physiology ,arterial stiffness, augmentation index, blood pressure, blood pressure telemonitoring, central arterial pressure, hypertension, pulse wave velocity, vascular biomarkers ,Renal function ,Hemodynamics ,Blood Pressure ,030204 cardiovascular system & hematology ,Pulse Wave Analysis ,Kidney ,Carotid Intima-Media Thickness ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Registries ,Pulse wave velocity ,Aged ,Settore MED/14 - Nefrologia ,business.industry ,Blood Pressure Determination ,Odds ratio ,Blood Pressure Monitoring, Ambulatory ,Middle Aged ,medicine.disease ,Pulse pressure ,Blood pressure ,Ambulatory ,Hypertension ,Cardiology ,Arterial stiffness ,Female ,Cardiology and Cardiovascular Medicine ,business ,Glomerular Filtration Rate - Abstract
Objective In this analysis of the telehealth-based Vascular health ASsessment Of The hypertENSive patients Registry, we checked how 24-h central and peripheral hemodynamics compare with hypertension-mediated organ damage (HMOD). Methods In 646 hypertensive patients (mean age 52 ± 16 years, 54% males, 65% treated) we obtained ambulatory brachial and central SBP and pulse pressure (PP), SBP, and PP variability, pulse wave velocity and augmentation index with a validated cuff-based technology. HMOD was defined by an increased left ventricular mass index (cardiac damage, evaluated in 482 patients), an increased intima-media thickness (vascular damage, n = 368), or a decreased estimated glomerular filtration rate or increased urine albumin excretion (renal damage, n = 388). Results Ambulatory SBP and PPs were significantly associated with cardiac damage: the largest odds ratio was observed for 24-h central SBP [1.032 (1.012, 1.051), P = 0.001] and PP [1.042 (1.015, 1.069), P = 0.002], the weakest for brachial estimates. The association was less strong for vascular damage with a trend to the superiority of 24-h central [1.036 (0.997, 1.076), P = 0.070] over brachial PP [1.031 (1.000, 1.062), P = 0.052]. No statistically significant association was observed for renal damage. SBP and PP variabilities, pulse wave velocity and augmentation index were not associated with any form of HMOD. In the multivariate analysis, age was associated with any type of HMOD, whereas central SBP and PP were predictive of an increased risk of cardiac damage. Conclusion In hypertensive patients a variable association exists between peripheral and central hemodynamics and various types of HMOD, with the most predictive power being observed for central SBP and PP for cardiac damage.
- Published
- 2019