P-259: Is there an association between blood pressure variability and target organ damage in diabetic and non-diabetic hypertensive patients?

• Published in: American journal of hypertension 2004-05, Vol.17 (S1), p.127A-127A
• Main Authors: Amado, Paula, Carmona, José P., Vasconcelos, Nuno, Alves, José, Nazaré, José
• Format: Article
• Language: English
• Subjects: Blood Pressure Variability; Microalbuminuria; Pulse Wave Velocity
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1016/j.amjhyper.2004.03.334

The frequency and severity of target organ damage have been shown to be greater in patients with high levels of BP variability. To evaluate the relationship of BP variability assessed by ambulatory Blood Pressure Monitoring (ABPM) as mean day systolic BP standard deviation (Day SD)and target organ damage (arterial distensibility, microalbuminuria, left ventricular hypertrophy). Type II diabetic and non diabetic hypertensive patients (pts), submitted to clinical evaluation, blood and urine analysis (microalbuminuria), ambulatory blood pressure monitoring (ABPM, Spacelabs), pulse wave velocity measurement (PWV, Complior), echocardiography exam. DM pts (n=113), mean age 63 years old, 56% male, 88% on antihypertensive therapy (70% ACEI or ARA, 40% diuretics), mean office (O) blood pressure (BP) 160±22/86±11, 24 H ABP 138±16/76±10, Day ABP 141±17/79±11, Night ABP 132±18/70±10, 27% dippers. Non-DM pts (n=49), mean age 58 years old, 63% male, 69% on antihypertensive therapy (55% ACEI or ARA, 55% diuretics), mean office (O) blood pressure (BP) 162±20/93±10, 24 H ABP 138±17/83±10, Day ABP 142±18/86±12, Night ABP 130±18/76±12, 47% dippers. There were no significant differences in the two populations concerning Day SD, microalbuminuria or PWV. A positive and significant correlation was found between Day SD and arterial distensibility in DM (r=0,34, p=0,001) and non DM(r=0,43, p=0,004). In DM population we found a trend to the association of Day SD tercis distribution and microalbuminuria and a significant correlation with morning rise (r=0,37, p=0,000). Results about LVH aren't yet available. In both populations (diabetic and non diabetic hypertensives, BP variability, associates a decrease in arterial distensibility and can be a signal of target organ damage. In Diabetic patients there is a tendency to the association of BP variability and microalbuminuria. (See Table)BP Variability and Arterial Distensibility PWV/SDTercis n 1st Tercil n 2nd Tercil n 3rd Tercil p DM 28 12,4 26 12,9 28 14,7 0,005 Non-DM 12 11,3 18 13 13 14,1 0,035