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Night-time home versus ambulatory blood pressure in determining target organ damage

Andreadis, Emmanuel A.; Agaliotis, Gerasimos; Kollias, Anastasios; Kolyvas, George; Achimastos, Apostolos; Stergiou, George S.

doi: 10.1097/HJH.0000000000000815
ORIGINAL PAPERS: BP measurement

Objective: This study aimed to evaluate the association of night-time blood pressure (BP) assessed by home blood pressure (HBP) or ambulatory blood pressure (ABP) monitoring with preclinical target organ damage in untreated hypertension.

Methods: Untreated hypertensive study participants were evaluated with ABP monitoring (24-h) and HBP monitoring during daytime (6 days, duplicate morning and evening measurements) and night-time (automated asleep measurements, three nights, 3-hourly measurements/night). Target organ damage was assessed by echocardiographic left ventricular mass index (LVMI), common carotid intima–media thickness (cIMT), urine albumin excretion (UAE), and ankle-brachial index (ABI).

Results: A total of 131 study participants were analysed [mean age 52.1 ± 11.9 (SD) years, BMI 29.9 ± 5.3 kg/m2, men 58%, cardiovascular disease history 6.1%]. Daytime and night-time HBP were slightly higher than the respective ABP values (mean difference for systolic daytime/night-time 3.5 ± 10.6/2.6 ± 9.8 mmHg, P < 0.01 for both comparisons and diastolic −0.3 ± 6.8/1.2 ± 6.2 mmHg, P = NS/0.02, respectively). There was a strong correlation between daytime ABP and HBP (r = 0.71/0.72, systolic/diastolic), as well as between the respective night-time values (r = 0.80/0.79; all P < 0.01). Night-time ABP and HBP presented strong and comparable correlations with all the indices of preclinical target organ damage. In multivariate analyses, both LVMI (R 2 = 0.26) and cIMT (R 2 = 0.25) were determined by night-time systolic HBP, age and male sex; UAE (R 2 = 0.28) by night-time systolic HBP and male sex; ABI (R 2 = 0.20) by male sex and night-time home pulse pressure.

Conclusion: In untreated hypertensives, night-time BP assessed by home monitoring appears to be as good as night-time ambulatory monitoring in determining preclinical target organ damage.

aFourth Department of Medicine, Evangelismos General Hospital

bHypertension Center, STRIDE-7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece

Correspondence to Professor George S. Stergiou, MD, FRCP, Hypertension Center, STRIDE-7, Third University Department of Medicine, Sotiria Hospital, 152 Mesogion Avenue, Athens 11527, Greece. Tel: +302107763117; fax: +302107719981; e-mail: gstergi@med.uoa.gr

Abbreviations: ABI, ankle-brachial index; ABP, ambulatory blood pressure; BP, blood pressure; HBP, home blood pressure; cIMT, carotid intima–media thickness; LVMI, left ventricular mass index; UAE, urine albumin excretion

Received 5 April, 2015

Revised 3 October, 2015

Accepted 2 November, 2015

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