Ambulatory blood pressure, target organ damage and aortic root size in never-treated essential hypertensive patients

C. Cuspidi, S. Meani, C. Valerio, A. Esposito, C. Sala, M. Maisaidi, A. Zanchetti, G. Mancia

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Abstract

The relationship between ambulatory blood pressure (ABP), target organ damage (TOD) and aortic root (AR) size in human hypertension has not been fully explored to date. We investigated the relationship between ABP, different markers of TOD and AR size in never-treated essential hypertensive patients. A total of 519 grade 1 and 2 hypertensive patients (mean age 46 ± 12 years) referred for the first time to our outpatient clinic underwent the following procedures: (1) routine examination, (2) 24 h urine collection for microalbuminuria (MA), (3) ambulatory blood pressure monitoring over two 24h periods within 4 weeks, (4) echocardiography and (5) carotid ultrasonography. AR dilatation was defined by sex-specific criteria (≥40mm in men and ≥37mm in women). AR diameter was increased in 3.7% of patients. Demographic variables (body mass index, age and male gender), average night-time diastolic blood pressure (BP) (but not clinic or average 48h BP), left ventricular mass index and carotid intima-media (IM) thickness showed an independent association with AR size in both univariate and multivariate analyses. When TOD data were analysed in a categorical way, a stepwise increase in the prevalence of left ventricular hypertrophy (LVH) (I = 17.5%, II = 27.6%, III = 35.8%) and carotid IM thickening (I = 20.9%, II = 28.8%, III = 34.4%), but not in MA (I = 6.8%, II = 9.1%, III = 8.7%) was found with the progression of AR size tertiles. Our results show that (1) AR enlargement in uncomplicated never-treated hypertensive patients has a markedly lower prevalence than traditional markers of cardiac and extracardiac TOD; (2) night-time BP, LVH and carotid IM thickening are independent predictors of AR dimension.

Original languageEnglish
Pages (from-to)531-538
Number of pages8
JournalJournal of Human Hypertension
Volume21
Issue number7
DOIs
Publication statusPublished - Jul 2007

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Blood Pressure
Left Ventricular Hypertrophy
Urine Specimen Collection
Carotid Intima-Media Thickness
Ambulatory Blood Pressure Monitoring
Ambulatory Care Facilities
Echocardiography
Dilatation
Ultrasonography
Body Mass Index
Multivariate Analysis
Demography
Hypertension

ASJC Scopus subject areas

  • Internal Medicine

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Ambulatory blood pressure, target organ damage and aortic root size in never-treated essential hypertensive patients. / Cuspidi, C.; Meani, S.; Valerio, C.; Esposito, A.; Sala, C.; Maisaidi, M.; Zanchetti, A.; Mancia, G.

In: Journal of Human Hypertension, Vol. 21, No. 7, 07.2007, p. 531-538.

Research output: Contribution to journalArticle

Cuspidi, C. ; Meani, S. ; Valerio, C. ; Esposito, A. ; Sala, C. ; Maisaidi, M. ; Zanchetti, A. ; Mancia, G. / Ambulatory blood pressure, target organ damage and aortic root size in never-treated essential hypertensive patients. In: Journal of Human Hypertension. 2007 ; Vol. 21, No. 7. pp. 531-538.
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abstract = "The relationship between ambulatory blood pressure (ABP), target organ damage (TOD) and aortic root (AR) size in human hypertension has not been fully explored to date. We investigated the relationship between ABP, different markers of TOD and AR size in never-treated essential hypertensive patients. A total of 519 grade 1 and 2 hypertensive patients (mean age 46 ± 12 years) referred for the first time to our outpatient clinic underwent the following procedures: (1) routine examination, (2) 24 h urine collection for microalbuminuria (MA), (3) ambulatory blood pressure monitoring over two 24h periods within 4 weeks, (4) echocardiography and (5) carotid ultrasonography. AR dilatation was defined by sex-specific criteria (≥40mm in men and ≥37mm in women). AR diameter was increased in 3.7{\%} of patients. Demographic variables (body mass index, age and male gender), average night-time diastolic blood pressure (BP) (but not clinic or average 48h BP), left ventricular mass index and carotid intima-media (IM) thickness showed an independent association with AR size in both univariate and multivariate analyses. When TOD data were analysed in a categorical way, a stepwise increase in the prevalence of left ventricular hypertrophy (LVH) (I = 17.5{\%}, II = 27.6{\%}, III = 35.8{\%}) and carotid IM thickening (I = 20.9{\%}, II = 28.8{\%}, III = 34.4{\%}), but not in MA (I = 6.8{\%}, II = 9.1{\%}, III = 8.7{\%}) was found with the progression of AR size tertiles. Our results show that (1) AR enlargement in uncomplicated never-treated hypertensive patients has a markedly lower prevalence than traditional markers of cardiac and extracardiac TOD; (2) night-time BP, LVH and carotid IM thickening are independent predictors of AR dimension.",
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