title: Beat-to-beat, reading-to-reading, and day-to-day blood pressure variability in relation to organ damage in untreated Chinese.
abstract: Whether target organ damage is associated with blood pressure (BP) variability independent of level remains debated. We assessed these associations from 10-minute beat-to-beat, 24-hour ambulatory, and 7-day home BP recordings in 256 untreated subjects referred to a hypertension clinic. BP variability indices were variability independent of the mean, maximum-minimum difference, and average real variability. Effect sizes (standardized β) were computed using multivariable regression models. In beat-to-beat recordings, left ventricular mass index (n=128) was not (P≥0.18) associated with systolic BP but increased with all 3 systolic variability indices (+2.97-3.53 g/m(2); P<0.04); the urinary albumin-to-creatinine ratio increased (P≤0.03) with systolic BP (+1.14-1.17 mg/mmol) and maximum-minimum difference (+1.18 mg/mmol); and pulse wave velocity increased with systolic BP (+0.69 m/s; P<0.001). In 24-hour recordings, all 3 indices of organ damage increased (P<0.03) with systolic BP, whereas the associations with BP variability were nonsignificant (P≥0.15) except for increases in pulse wave velocity (P<0.05) with variability independent of the mean (+0.16 m/s) and maximum-minimum difference (+0.17 m/s). In home recordings, the urinary albumin-to-creatinine ratio (+1.27-1.30 mg/mmol) and pulse wave velocity (+0.36-0.40 m/s) increased (P<0.05) with systolic BP, whereas all associations of target organ damage with the variability indices were nonsignificant (P≥0.07). In conclusion, while accounting for BP level, associations of target organ damage with BP variability were readily detectable in beat-to-beat recordings, least noticeable in home recordings, with 24-hour ambulatory monitoring being informative only for pulse wave velocity.
authors.affiliation: Shanghai Institute of Hypertension, Shanghai Jiaotong University School of Medicine, Ruijin 2nd Rd 197, Shanghai 200025, China. liyanshcn@yahoo.com.
authors.forename: Fang-Fei
authors.initials: FF
authors.lastname: Wei
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.forename: Ting-Yan
authors.initials: TY
authors.lastname: Xu
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Ding
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D000328:Adult; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D002940:Circadian Rhythm / Q000502:physiology*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin; D003404:Creatinine
keywords: blood pressure monitoring, ambulatory; blood pressure monitoring, home; clinical laboratory science