Value of Home Blood Pressures as Predictor of Target Organ Damage in Mild Arterial Hypertension

Home blood pressure measurement has gained increasing importance for the management of hypertensive patients. The aim of our study was to compare levels of clinic (CBP), ambulatory (ABP), and home blood pressure (HBP) measurements, and their relationships with various indexes of target organ damage in I-II grade essential hypertension.Thirty-eight essential hypertensives underwent evaluation of clinic, ambulatory and home blood pressures. Each patient recorded HBP for 2 days with a digital BP monitor three times daily, the first time on the same day during which ABP monitoring was simultaneously performed. Moreover, in all subjects electrocardiogram recording, echocardiographic study, micro…

Influence of metabolic syndrome on hypertension-related target organ damage

Value of home blood pressure as predictor of target organ damage in mild arterial hypertension

Relationship between aortic stiffness and albumin excretion rate in untreated essential hypertensive patients

Sympathetic Overactivity and 24-Hour Blood Pressure Pattern in Hypertensives with Chronic Renal Failure

In order to assess the activity of the sympathetic system and to evaluate the 24-h blood pressure pattern in hypertensives with chronic renal failure (CRF), 12 CRF patients and 16 essential hypertensives (EHs) were studied. In all subjects, plasma samples for catecholamines and renin activity were obtained both in the basal condition and after standing, and 24-h blood pressure monitoring (ABPM) was performed. The 24-h mean blood pressure results were quite similar between CRFs and EHs. In 50% of the CRFs, ABPM showed a nighttime decrease in diastolic BP (DBP) greater than 10%, while in the remaining 50% the ABPM indicated a nondipper blood pressure pattern. Of the 16 EHs, 4 had a nighttime …

Relationships between 24 h blood pressure load and target organ damage in patients with mild-to-moderate essential hypertension.

Objective: To analyse the relationships between 24 h blood pressure load (the percentage of systolic/diastolic blood pressures exceeding 140/90 mmHg while awake and 120/80 mmHg during sleep) and some indices of hypertensive target organ involvement, independently of the mean level of 24 h blood pressure. Methods: One hundred and thirty patients with mild-to-moderate hypertension underwent 24 h ambulatory blood pressure monitoring, ocular fundus examination, microalbuminuria assay and two-dimensional guided M-mode echocardiography. The study population was divided into subsets according to the systolic and diastolic 24 h blood pressure load values predicted from the regression equation relat…

Influenza della sindrome metabolica sulla stiffness aortica in ipertesi essenziali mai trattati farmacologicamente

Influence of metabolic syndrome on hypertension-related target organ damage

MuleG, Nardi E, Cottone S, Cusimano P, Volpe V, Piazza G, MongioviR, Mezzatesta G, Andronico G, Cerasola G (Universitadi Palermo, Palermo, Italy). Influence of metabolic syndrome on hypertension-related target organ damage. J Intern Med 2005; 257: 503-513. Objectives. The aim of our study was to analyse, in a wide group of essential hypertensive patients without diabetes mellitus, the influence of metabolic syndrome (MS) (defined according to the criteria laid down in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults) on markers of preclinical cardiac, renal and retinal damage. Design. Cros…

Influence of the metabolic syndrome on aortic stiffness in never treated hypertensive patients

Summary Background and aim Metabolic syndrome (MS) carries an increased risk for cardiovascular events and there is a growing awareness that large artery stiffening is a powerful predictor of cardiovascular morbidity and mortality. Little is known about the relationship of MS with aortic stiffness. The aim of our study was to analyze, in patients with essential hypertension, the influence of MS, defined according to the criteria proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III), on carotid–femoral pulse wave velocity (PWV), a measure of aortic stiffness. Methods N…

Relationships of “ambulatory” white coat effect with target organ damage in arterial hypertension

Relazione tra microalbuminuria e velocità dell’onda sfigmica in ipertesi mai trattati farmacologicamente.

Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives

In order to explore the relations between left ventricularmass (LVM) and the pulsatile (pulse pressure) andsteady (mean pressure) components of the bloodpressure (BP) curve, 304 young and middle-agedessential hypertensive patients were studied by meansof 24-h ambulatory BP monitoring and echocardio-graphy. In the overall study population, both the BPcomponents showed significant correlations with LVM.These correlations were unevenly distributed in thesubgroups of subjects younger and in those older than50 years. While in this latter subgroup, in multivariateanalysis, both 24-h mean BP (24-MBP) (b¼0.27;P¼0.008) and 24-h pulse pressure (24-h PP) (b¼0.23;P¼0.02) were associated with LVM, in th…

Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives

In order to explore the relations between left ventricular mass (LVM) and the pulsatile (pulse pressure) and steady (mean pressure) components of the blood pressure (BP) curve, 304 young and middle-aged essential hypertensive patients were studied by means of 24-h ambulatory BP monitoring and echocardiography. In the overall study population, both the BP components showed significant correlations with LVM. These correlations were unevenly distributed in the subgroups of subjects younger and in those older than 50 years. While in this latter subgroup, in multivariate analysis, both 24-h mean BP (24-MBP) (beta = 0.27; P = 0.008) and 24-h pulse pressure (24-h PP) (beta = 0.23; P = 0.02) were a…

Influenza della sindrome metabolica sulla massa del ventricolo sinistro nell’iperteso obeso

Relationship between albumin excretion rate and aortic stiffness in untreated essential hypertensive patients

. Objectives.  To evaluate, in a group of nondiabetic essential hypertensive patients with normal renal function, the relationship between albumin excretion rate (AER) and carotid-femoral pulse wave velocity (PWV), as an index of aortic stiffness. Design.  Cross-sectional study. Setting.  Outpatient hypertension clinic. Subjects.  Seventy patients with mild-to-moderate essential hypertension, aged 42 ± 8 years, never pharmacologically treated. All subjects underwent routine laboratory tests, 24-h ambulatory blood pressure (BP) monitoring, measurement of carotid-femoral PWV, by means of a computerized method, and AER. Results.  Microalbuminuric patients (AER ≥ 20 μg min−1; n = 19), when comp…

Relationship between metabolic syndrome and aortic stiffness in untreated hypertensive patients

Sindrome metabolica e danno d’organo nell’ipertensione arteriosa essenziale.

Relationships between ambulatory white coat effect and left ventricular mass in arterial hypertension

The aim of our study was to analyze, in a group of 296 essential hypertensives, the relationship between left ventricular mass (LVM) and ambulatory white coat effect (WCE); that is the difference between the elevation of the first measurements of ambulatory blood pressure monitoring and the mean daytime pressure. The study population was separated into two groups according to the median of the WCE. The LVM was greater in the groups with higher systolic and diastolic ambulatory WCE. The significant association between ambulatory WCE and LVM was confirmed by the results of multiple regression analysis, suggesting that ambulatory WCE may not be an innocent phenomenon.

Aortic stiffness in untreated hypertensive patients: influence of metabolic syndrome

Relazione tra stiffness aortica e catecolamine plasmatiche in ipertesi essenziali mai trattati farmacologicamente.

Microalbuminuria, renal dysfunction and cardiovascular complication in essential hypertension

To evaluate the prevalence of microalbuminuria (albumin excretion rate, AER) in a wide hypertensive population, and to evaluate any relationship with cardiovascular damage and renal dysfunction.A transversal study.In 383 hospitalized Caucasian essential hypertensives (198 men, 185 women) of mean age 44 +/- 0.5 years and mean clinic blood pressure 170.3 +/- 0.95/ 103.4 +/- 0.47 mmHg, metabolic parameters, serum creatinine level (Cs), creatinine clearance rate (Ccs), 24 AER and plasma renin activity (PRA) were measured. Furthermore, each patient underwent 24 h ambulatory blood pressure monitoring (ABPM) and echocardiography to measure left ventricular mass, which was indexed both by body surf…

Ipertrofia ventricolare sinistra nell’iperteso obeso: influenza della sindrome metabolica

Influence of the calcium antagonist amlodipine on left ventricular mass and function in patients with essential hypertension

This study was conducted to evaluate the influence of antihypertensive treatment with the calcium antagonist amlodipine on left ventricular structure and systolic and diastolic function in patients with essential hypertension.

Metabolic syndrome amplifies hypertension-related target organ damage

White-coat hypertension and cardiovascular risk

OBJECTIVE: To compare cardiovascular risk in white-coat hypertensives, normotensives and established hypertensives. METHODS: We studied 61 hypertensive individuals, 27 of whom were white-coat hypertensives, and 35 normotensives. All subjects underwent 24 h noninvasive blood pressure monitoring and Doppler echocardiographic examination of the heart; urine was tested for microalbuminuria and the fundi of the eyes examined for retinopathy. RESULTS: The 24 h as well as the day- and night-time mean systolic blood pressure (SBP) was slightly but significantly higher in white-coat hypertensives than in normotensives; no significant difference was observed in diastolic blood pressure (DBP) between …