Self-Measured Blood Pressure and Target Organ Damage in Newly Detected Hypertension in South Gujarat, India

Authors

  • Harshil Patel Surat Municipal Institute of Medical Education and Research, Surat, India
  • Ashok Gagiya Surat Municipal Institute of Medical Education and Research, Surat, India
  • Vivek Gurjar Surat Municipal Institute of Medical Education and Research, Surat, India
  • Chintan Patil Surat Municipal Institute of Medical Education and Research, Surat, India

DOI:

https://doi.org/10.55489/njcm.140120232734

Keywords:

Systolic blood pressure, Diastolic blood pressure, Left ventricular mass index, Carotid intima media thickness, Urine albumin/creatinine ratio

Abstract

Introduction: Blood pressure transient spikes have been considered to be noise and only a hindrance to a proper assessment of typical blood pressure, which is defined as the actual underlying average blood pressure over a long period of time. The current study aimed to see if the highest Self measured Systolic blood Pressure could be utilized to forecast the occurrence of Target organ damage and evaluate the independent association between the maximum Self measured Systolic blood Pressure and Target organ damage in individuals with untreated hyper-tension.

Method: We evaluated the urine albumin/creatinine ratio (UACR) and carotid intima-media thickness (IMT) us-ing ultrasonography in 462 hypertensive individuals who had never taken treatment for their hypertension. Resi-dential blood pressure was recorded.

Result: The maximal Self measured Systolic blood Pressure had considerably higher association coefficients with left ventricular mass index (LVMI) and carotid intima-media thickness than the mean Self measured Systolic blood Pressure. Irrespective of the mean Self measured Blood pressure level, multivariate regression studies showed that the maximal Self measured Systolic blood Pressure was independently related with left ventricular mass index and carotid intima-media thickness.

Conclusion: Transiently high blood pressure measurements recorded at Self measured shouldn't be dismissed as noise but rather taken seriously as significant warning signs of hypertensive Target organ damage in the heart and arteries.

References

Rothwell PM. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hyper-tension. Lancet. 2010;375:938 -948. Doi: https://doi.org/10.1016/S0140-6736(10)60309-1 PMid:20226991

Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlo¨f B, Sever PS, Poulter NR. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375:895-905. Doi: https://doi.org/10.1016/S0140-6736(10)60308-X PMid:20226988

Ko Y, Park JH, Yang MH, Ko SB, Han MK, Oh CW, Lee J, Lee J, Bae HJ. The significance of blood pressure variability for the develop-ment of hemorrhagic transformation in acute ischemic stroke. Stroke. 2010;41: 2512-2518. Doi: https://doi.org/10.1161/STROKEAHA.110.595561 PMid:20947842

Shimbo D, Pickering TG, Spruill TM, Abraham D, Schwartz JE, Gerin W. Relative utility of home, ambulatory, and office blood pressures in the prediction of end-organ damage. Am J Hypertens. 2007;20:476 - 482. Doi: https://doi.org/10.1016/j.amjhyper.2006.12.011 PMid:17485006 PMCid:PMC1931502

Stergiou GS, Argyraki KK, Moyssakis I, Mastorantonakis SE, Achi- mastos AD, Karamanos VG, Roussias LG. Home blood pressure is as reliable as ambulatory blood pressure in predicting target-organ damage in hypertension. Am J Hypertens. 2007;20:616 - 621. Doi: https://doi.org/10.1016/j.amjhyper.2006.12.013 PMid:17531917

Niiranen TJ, Jula AM, Kantola IM, Karanko H, Reunanen A. Home- measured blood pressure is more strongly associated with elec-trocardio- graphic left ventricular hypertrophy than is clinic blood pressure: the Finn-HOME study. J Hum Hypertens. 2007;21:788 -794. Doi: https://doi.org/10.1038/sj.jhh.1002192 PMid:17637793

Niiranen T, Jula A, Kantola I, Moilanen L, Ka¨ho¨nen M, Kesa¨niemi YA, Nieminen MS, Reunanen A. Home-measured blood pressure is more strongly associated with atherosclerosis than clinic blood pressure: the Finn-HOME Study. J Hypertens. 2007;25:1225-1231. Doi: https://doi.org/10.1097/HJH.0b013e3280d94336 PMid:17563535

Tachibana R, Tabara Y, Kondo I, Miki T, Kohara K. Home blood pressure is a better predictor of carotid atherosclerosis than office blood pressure in community-dwelling subjects. Hypertens Res. 2004;27: 633- 639. Doi: https://doi.org/10.1291/hypres.27.633 PMid:15750256

Matsui Y, Eguchi K, Ishikawa J, Hoshide S, Shimada K, Kario K. Subclinical arterial damage in untreated masked hypertensive sub-jects detected by home blood pressure measurement. Am J Hypertens. 2007; 20:385-391. Doi: https://doi.org/10.1016/j.amjhyper.2006.10.008 PMid:17386344

Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, Nishiyama A, Aihara A, Sekino M, Kikuya M, Ito S, Satoh H, Hisamichi S. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based obser- vation in Ohasama, Japan. J Hypertens. 1998;16:971-975. Doi: https://doi.org/10.1097/00004872-199816070-00010 PMid:9794737

Niiranen TJ, Ha¨nninen MR, Johansson J, Reunanen A, Jula AM. Home- measured blood pressure is a stronger predictor of cardio-vascular risk than office blood pressure: the Finn-Home study. Hypertension. 2010;55: 1346 -1351. Doi: https://doi.org/10.1161/HYPERTENSIONAHA.109.149336 PMid:20385970

Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Management of Arterial Hypertension of the European Soci-ety of Hypertension; European Society of Car- diology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105-1187. Doi: https://doi.org/10.1097/HJH.0b013e3281fc975a

Schillaci G, Verdecchia P, Porcellati C, Cuccurullo O, Cosco C, Perticone F. Continuous relation between left ventricular mass and cardiovascular risk in essential hypertension. Hypertension. 2000;35:580 -586. Doi: https://doi.org/10.1161/01.HYP.35.2.580 PMid:10679501

O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340:14 -22. Doi: https://doi.org/10.1056/NEJM199901073400103 PMid:9878640

Wachtell K, Ibsen H, Olsen MH, Borch-Johnsen K, Lindholm LH, Mogensen CE, Dahlo¨f B, Devereux RB, Beevers G, de Faire U, Fyhr-quist F, Julius S, Kjeldsen SE, Kristianson K, Lederballe-Pedersen O, Nieminen MS, Okin PM, Omvik P, Oparil S, Wedel H, Snapinn SM, Aurup P. Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy: the LIFE study. Ann In-tern Med. 2003; 139:901-906. Doi: https://doi.org/10.7326/0003-4819-139-11-200312020-00008 PMid:14644892

Matsui Y, Eguchi K, Shibasaki S, Shimizu M, Ishikawa J, Shimada K, Kario K. Association between the morning-evening difference in home blood pressure and cardiac damage in untreated hypertensive patients. J Hypertens. 2009;27:712-720. Doi: https://doi.org/10.1097/HJH.0b013e3283260681 PMid:19516171

Polo'nia J, Amado P, Barbosa L, Nazare' J, Silva JA, Bertoquini S, Martins L, Carmona J. Morning rise, morning surge and daytime varia-bility of blood pressure and cardiovascular target organ damage. A cross-sectional study in 743 subjects. Rev Port Cardiol. 2005;24:65-78.

Eguchi K, Tomizawa H, Ishikawa J, Hoshide S, Pickering TG, Shimada K, Kario K. Factors associated with baroreflex sensitivity: as-sociation with morning blood pressure. Hypertens Res. 2007;30:723-728. Doi: https://doi.org/10.1291/hypres.30.723 PMid:17917320

Johansson JK, Niiranen TJ, Puukka PJ, Jula AM. Factors affecting the variability of home-measured blood pressure and heart rate: the Finn-home study. J Hypertens. 2010;28:1836 -1845. Doi: https://doi.org/10.1097/HJH.0b013e32833b6c8a PMid:20508528

Kato T, Kikuya M, Ohkubo T, Satoh M, Hara A, Obara T, Metoki H, Asayama K, Hirose T, Inoue R, Kanno A, Totsune K, Hoshi H, Satoh H, Imai Y. Factors associated with day-by-day variability of self-measured blood pressure at home: the Ohasama study. Am J Hy-pertens. 2010;23: 980 -986. Doi: https://doi.org/10.1038/ajh.2010.94 PMid:20448533

Gobbin B, Pickering TG, Sleight P, Peto R. Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res. 1971;29:424 - 431. Doi: https://doi.org/10.1161/01.RES.29.4.424 PMid:5110922

Lantelme P, Khettab F, Custaud MA, Rial MO, Joanny C, Gharib C, Milon H. Spontaneous baroreflex sensitivity: toward an ideal index of cardiovascular risk in hypertension? J Hypertens. 2002;20:935-944. Doi:https://doi.org/10.1097/00004872-200205000-00029 PMid:12011655

Gianaros PJ, Jennings JR, Olafsson GB, Steptoe A, Sutton-Tyrrell K, Muldoon MF, Manuck SB. Greater intima-media thickness in the carotid bulb is associated with reduced baroreflex sensitivity. Am J Hypertens. 2002;15:486 - 491. Doi: https://doi.org/10.1016/S0895-7061(02)02923-0 PMid:12074348

Tatasciore A, Renda G, Zimarino M, Soccio M, Bilo G, Parati G, Schillaci G, De Caterina R. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension. 2007;50: 325-332. Doi: https://doi.org/10.1161/HYPERTENSIONAHA.107.090084 PMid:17562971

Griffin KA, Picken MM, Bidani AK. Deleterious effects of calcium channel blockade on pressure transmission and glomerular injury in rat remnant kidneys. J Clin Invest. 1995;96:793- 800. Doi: https://doi.org/10.1172/JCI118125 PMid:7635974 PMCid:PMC185265

Ishikawa J, Kario K, Hoshide S, Eguchi K, Morinari M, Kaneda R, Umeda Y, Ishikawa S, Kuroda T, Hojo Y, Shimada K. J-MORE Study Group. Determinants of exaggerated difference in morning and evening blood pressure measured by self-measured blood pressure monitoring in medicated hypertensive patients: Jichi Morning Hypertension Research (J-MORE) Study. Am J Hypertens. 2005;18:958 -965. Doi: https://doi.org/10.1016/j.amjhyper.2005.01.013 PMid:16053993

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Published

2023-01-31

How to Cite

1.
Patel H, Gagiya A, Gurjar V, Patil C. Self-Measured Blood Pressure and Target Organ Damage in Newly Detected Hypertension in South Gujarat, India. Natl J Community Med [Internet]. 2023 Jan. 31 [cited 2024 Apr. 23];14(01):59-64. Available from: https://njcmindia.com/index.php/file/article/view/2734

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Original Research Articles