OR-59: Predictors of sustained hypertension in subjects with borderline to mild hypertension. A 5-year follow-up of the HARVEST study

• Published in: American journal of hypertension 2002-04, Vol.15 (S3), p.27A-27A
• Main Authors: Palatini, Paolo, Mormino, Paolo, Mattarei, Mauro, De Venuto, Giuseppe, Graniero, Gianrocco, Laurini, Giorgio, Bortolazzi, Alessandra, Canali, Cristina, Pessina, Achille C.
• Format: Article
• Language: English
• Subjects: Ambulatory Blood Pressure; Borderline Hypertension; Nondippers
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(02)02338-5

The aim of the present study was to assess the relative role of repeated clinic blood pressure (BP) measurement, mean 24h BP, and diurnal BP rhythm in predicting the development of sustained hypertension in subjects with borderline to mild hypertension. We studied prospectively 1062 (771 males), never treated, stage I young hypertensive subjects from the multicenter HARVEST study. All subjects underwent 24h ambulatory monitoring at baseline and repeated clinic BP measurement during the first six months of follow-up. Patients were classified as nondippers, dippers, or extreme dippers according to whether their night-time systolic BP fall was 20% daytime values, respectively. The independent prediction of clinic BP, of 24h BP and of the nondipper condition for outcome was tested in a multivariable Cox analysis controlling for possible confounders. During a mean (95%CL) follow-up of 68 (65-71) months, 236 subjects developed sustained hypertension (clinic diastolic BP permanently > 99 mmHg) and were started on antihypertensive treatment. At baseline, 329 subjects were classified as nondippers, 617 as dippers, and 116 as extreme dippers. The three groups were balanced for sex distribution, and had similar age (33±9, 33±8, and 32±8 years, respectively; n.s.) and baseline clinic BP (145±10/94±6, 146±11/94±6, and 146±11/94±5 mmHg, respectively; n.s.). Night-time systolic BP fall was 7±6, 20±4 and 32±5 mmHg, respectively, in the three groups. When only baseline data were used, mean 24h BP was the strongest predictor of outcome (p