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The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population

Background and Objectives: Hypertensive heart disease, especially left ventricular hypertrophy (LVH), is considered to be one of the main types hypertension-mediated organ damage. Hence, the purpose of this study was to examine which method of measuring BP (office BP measurement (OBPM), 24 h ambulat...

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Autores principales: Antza, Christina, Tziomalos, Georgios, Kostopoulos, Georgios, Trakatelli, Christina, Kotsis, Vasilios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537443/
https://www.ncbi.nlm.nih.gov/pubmed/37763755
http://dx.doi.org/10.3390/medicina59091636
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author Antza, Christina
Tziomalos, Georgios
Kostopoulos, Georgios
Trakatelli, Christina
Kotsis, Vasilios
author_facet Antza, Christina
Tziomalos, Georgios
Kostopoulos, Georgios
Trakatelli, Christina
Kotsis, Vasilios
author_sort Antza, Christina
collection PubMed
description Background and Objectives: Hypertensive heart disease, especially left ventricular hypertrophy (LVH), is considered to be one of the main types hypertension-mediated organ damage. Hence, the purpose of this study was to examine which method of measuring BP (office BP measurement (OBPM), 24 h ambulatory BP monitoring (ABPM), or home BP monitoring (HBPM)), can be better correlated with echocardiographic LVH in the untreated hypertensive population. Materials and Methods: This study’s population consisted of 202 patients 58 ± 15 years old (40.8% males). All patients reported elevated home BP measurements for at least 3 months, but they had never been treated before for hypertension. Office and out-of-office BP measurements, including ABPM on a usual working day and seven-day HBPM, as well as 2D echocardiography, were performed. Results: In the univariate analysis, LVH was associated (p < 0.05) with a mean 24 h systolic BP (OR: 1.93, CI: 1.29–2.91), a mean 24 h diastolic BP (OR: 1.30, CI: 1.16–1.80), ambulatory daytime systolic (OR: 1.11, CI:1.01–1.82) and diastolic BP (OR: 1.13, CI:1.09–1.17), ambulatory nighttime systolic BP (OR: 2.11, CI: 1.04–4.31), and mean home systolic BP (OR: 1.05, CI:1.01–1.12). Pearson’s correlation analysis showed a significant correlation between the LV mass index and the mean 24 h systolic BP (r = 0.58, p < 0.05), daytime systolic BP (r = 0.59, p < 0.05), and nighttime systolic BP (r = 0.57, p < 0.05). Most of the population with confirmed LVH presented confirmed hypertension (based on ABPM, 48.1% or HBPM, 40%). The second most dominant phenotype was masked hypertension (ABPM, 32.7% and HBPM, 23.7%). The majority (59.3%) had non-dipping status, 20.4% had a reverse dipping pattern, 13% had a dipping pattern, and only 7.3% had extreme dipping BP. Conclusions: Out-of-office BP measurement devices seemed to be superior compared to in-office. This advantage is highlighted by better correlations in the identification of LVH as well as the diagnosis of masked hypertension, a condition also highly correlated with LVH.
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spelling pubmed-105374432023-09-29 The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population Antza, Christina Tziomalos, Georgios Kostopoulos, Georgios Trakatelli, Christina Kotsis, Vasilios Medicina (Kaunas) Article Background and Objectives: Hypertensive heart disease, especially left ventricular hypertrophy (LVH), is considered to be one of the main types hypertension-mediated organ damage. Hence, the purpose of this study was to examine which method of measuring BP (office BP measurement (OBPM), 24 h ambulatory BP monitoring (ABPM), or home BP monitoring (HBPM)), can be better correlated with echocardiographic LVH in the untreated hypertensive population. Materials and Methods: This study’s population consisted of 202 patients 58 ± 15 years old (40.8% males). All patients reported elevated home BP measurements for at least 3 months, but they had never been treated before for hypertension. Office and out-of-office BP measurements, including ABPM on a usual working day and seven-day HBPM, as well as 2D echocardiography, were performed. Results: In the univariate analysis, LVH was associated (p < 0.05) with a mean 24 h systolic BP (OR: 1.93, CI: 1.29–2.91), a mean 24 h diastolic BP (OR: 1.30, CI: 1.16–1.80), ambulatory daytime systolic (OR: 1.11, CI:1.01–1.82) and diastolic BP (OR: 1.13, CI:1.09–1.17), ambulatory nighttime systolic BP (OR: 2.11, CI: 1.04–4.31), and mean home systolic BP (OR: 1.05, CI:1.01–1.12). Pearson’s correlation analysis showed a significant correlation between the LV mass index and the mean 24 h systolic BP (r = 0.58, p < 0.05), daytime systolic BP (r = 0.59, p < 0.05), and nighttime systolic BP (r = 0.57, p < 0.05). Most of the population with confirmed LVH presented confirmed hypertension (based on ABPM, 48.1% or HBPM, 40%). The second most dominant phenotype was masked hypertension (ABPM, 32.7% and HBPM, 23.7%). The majority (59.3%) had non-dipping status, 20.4% had a reverse dipping pattern, 13% had a dipping pattern, and only 7.3% had extreme dipping BP. Conclusions: Out-of-office BP measurement devices seemed to be superior compared to in-office. This advantage is highlighted by better correlations in the identification of LVH as well as the diagnosis of masked hypertension, a condition also highly correlated with LVH. MDPI 2023-09-09 /pmc/articles/PMC10537443/ /pubmed/37763755 http://dx.doi.org/10.3390/medicina59091636 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Antza, Christina
Tziomalos, Georgios
Kostopoulos, Georgios
Trakatelli, Christina
Kotsis, Vasilios
The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title_full The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title_fullStr The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title_full_unstemmed The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title_short The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
title_sort importance of out-of-office blood pressure measurement, as highlighted by the correlation with left ventricular hypertrophy in an untreated hypertensive population
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10537443/
https://www.ncbi.nlm.nih.gov/pubmed/37763755
http://dx.doi.org/10.3390/medicina59091636
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