title: Correlation of Central Blood Pressure to Hypertensive Target Organ Damages During Antihypertensive Treatment: The J-TOP Study.
abstract: BACKGROUND
  Some previous studies have shown that central blood pressure (BP) is more closely related to cardiovascular risks than brachial BP. This study compared the correlations between asymptomatic organ damages and each of central BP, brachial clinic BP, and home BP during antihypertensive treatment.
  
  
  METHODS
  In the Japan Morning Surge-Target Organ Protection (J-TOP) study, which compared bedtime or awakening dosing of candesartan (+diuretics as needed) among subjects with home systolic BP (SBP) higher than 135 mm Hg, we evaluated 180 hypertensive patients who successfully underwent pulse wave analysis by HEM-9000AI and measured their urinary albumin/creatinine ratio (UACR) and left ventricular mass index (LVMI) (n = 144) at baseline and after 6 months of treatment.
  
  
  RESULTS
  During antihypertensive treatment, significant reductions were found in central SBP, UACR, and LVMI (all P < 0.001). Multiple regression analyses showed that the decrease in central SBP was associated with those of log-transformed UACR (β = 0.24, P < 0.01) and LVMI (β = 0.23, P = 0.04), independently of the decrease in both clinic and home SBP. The goodness-of-fit of the association between the reduction in SBP and the UACR (P < 0.01) or LVMI (P = 0.04) was improved by adding central SBP to the SBP measurement.
  
  
  CONCLUSIONS
  These findings suggest that the change in central BP could be an important therapeutic target during antihypertensive treatment, in addition to peripheral clinic and home BP.
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan;
authors.forename: Motohiro
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Ishikawa
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Eguchi
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. kkario@jichi.ac.jp.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000517:prevention & control* / Q000652:urine; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage*; D001713:Biphenyl Compounds; D001794:Blood Pressure; D001916:Brachial Artery; D003404:Creatinine / Q000652:urine; D004232:Diuretics / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000517:prevention & control*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D017534:Radial Artery; D013777:Tetrazoles / Q000008:administration & dosage*; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D004232:Diuretics; D013777:Tetrazoles; D003404:Creatinine; C081643:candesartan
keywords: angiotensin receptor blockade; antihypertensive treatment; blood pressure; central blood pressure; home blood pressure; hypertension; left ventricular hypertrophy; microalbuminuria.