Out-of-office BP reveals target organ damage in young individuals
Out-of-office rather than office blood pressure (OBP) generally determines target organ damage in young individuals, suggests a recent study. In addition, home and ambulatory BP show similar associations with preclinical organ damage.
The investigators assessed individuals referred for elevated BP and healthy volunteers aged 6–25 years with OBP (two to three visits), 7-day home (H)BP and 24-h ambulatory (A)BP monitoring.
Organ damage was evaluated with echocardiographic left ventricular mass index (LVMI), carotid ultrasonography (intima-media thickness [IMT]) and pulse wave velocity (PWV) using piezo-electronic or oscillometric technique.
Of the 251 individuals (mean age, 14 years; 70.9 percent men; 31.1 percent children; 54.6 percent adolescents; 14.3 percent young adults) included in the analysis, 189 had LVMI, 123 IMT and 198 PWV measurements.
Office, ambulatory and home hypertension was diagnosed in 29.5 percent, 27.1 percent and 26.3 percent of participants, respectively. The agreement between OBP and ABP was 74.5 percent (kappa, 0.37) and HBP 76.1 percent (kappa, 0.41). A closer agreement was seen between HBP and ABP at 84.0 percent (kappa, 0.61).
LVMI showed similar associations with systolic OBP, 24-h ABP and HBP (r, 0.31/0.31/0.30; pall<0.01). Comparable correlations were also noted for IMT (r,0.33/0.32/0.37; pall<0.01) and piezo-electronic PWV (r, 0.55/0.53/0.52; pall<0.01). On the other hand, oscillometric PWV showed stronger associations with OBP than with ABP or HBP.
Linear regression analysis showed that night-time BP determined the variation of LVMI, HBP of IMT, and OBP and 24-h ABP of PWV.