Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: the VASOTENS Registry.

Autor:	Omboni S; Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.; Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow., Posokhov I; Hemodynamic Laboratory Ltd, Nizhniy Novgorod, Russian Federation., Parati G; Istituto Auxologico Italiano.; Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy., Arystan A; Department of Functional Diagnostics, Medical Center Hospital of President's Affairs Administration of The Republic of Kazakhstan, Astana, Kazakhstan., Tan I; Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia., Barkan V; Diagnostics Department, The Hospital within the Russian Railroad Network, Chita., Bulanova N; Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow., Derevyanchenko M; Volgograd State Medical University, Volgograd., Grigoricheva E; South Ural State Medical University, Chelyabinsk., Minyukhina I; Volga District Medical Center, Nizhniy Novgorod, Russian Federation., Mulè G; Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa, Policlinico Paolo Giaccone, Palermo, Italy., Orlova I; Lomonosov Moscow State University Clinic, Moscow, Russian Federation., Paini A; Dipartimento di Scienze Mediche e Chirurgiche, Università di Brescia, Medicina 2, Spedali Civili, Brescia, Italy., Peixoto Maldonado JM; Clínica da Aveleira, Instituto de Investigação e Formação Cardiovascular., Pereira T; Escola Superior de Tecnologia da Saúde de Coimbra, Instituto Politécnico de Coimbra, Coimbra, Portugal., Ramos-Becerra CG; Arterial Stiffness Laboratory, Department of Physiology, University of Guadalajara, Mexico., Tilea I; Second Internal Medicine Clinic, Department of Cardiology, County Emergency Clinical Hospital, University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania., Waisman G; Istituto Cardiovascular Lezica, Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2020 Apr; Vol. 38 (4), pp. 701-715.
DOI:	10.1097/HJH.0000000000002312
Abstrakt:	Objective: In this analysis of the telehealth-based Vascular health ASsessment Of The hypertENSive patients Registry, we checked how 24-h central and peripheral hemodynamics compare with hypertension-mediated organ damage (HMOD). Methods: In 646 hypertensive patients (mean age 52 ± 16 years, 54% males, 65% treated) we obtained ambulatory brachial and central SBP and pulse pressure (PP), SBP, and PP variability, pulse wave velocity and augmentation index with a validated cuff-based technology. HMOD was defined by an increased left ventricular mass index (cardiac damage, evaluated in 482 patients), an increased intima-media thickness (vascular damage, n = 368), or a decreased estimated glomerular filtration rate or increased urine albumin excretion (renal damage, n = 388). Results: Ambulatory SBP and PPs were significantly associated with cardiac damage: the largest odds ratio was observed for 24-h central SBP [1.032 (1.012, 1.051), P = 0.001] and PP [1.042 (1.015, 1.069), P = 0.002], the weakest for brachial estimates. The association was less strong for vascular damage with a trend to the superiority of 24-h central [1.036 (0.997, 1.076), P = 0.070] over brachial PP [1.031 (1.000, 1.062), P = 0.052]. No statistically significant association was observed for renal damage. SBP and PP variabilities, pulse wave velocity and augmentation index were not associated with any form of HMOD. In the multivariate analysis, age was associated with any type of HMOD, whereas central SBP and PP were predictive of an increased risk of cardiac damage. Conclusion: In hypertensive patients a variable association exists between peripheral and central hemodynamics and various types of HMOD, with the most predictive power being observed for central SBP and PP for cardiac damage.
Databáze:	MEDLINE
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