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Evolution of Target Organ Damage by Different Values of Self-Blood Pressure Measurement in Untreated Hypertensive Patients.
MedLine Citation:
PMID:  22914254     Owner:  NLM     Status:  Publisher    
BackgroundTo determine the prognostic value of various self-blood pressure (BP) monitoring (SBPM) cutoff at the time of diagnosis.MethodsCohort of 466 newly diagnosed and never-treated hypertensive patients. At baseline and at 1 year, the patients underwent a physical examination, clinic BP (CBP), SBPM, and ambulatory BP monitoring (ABPM), fasting blood and urine analysis, electrocardiogram (ECG), and retinography. The diagnosis of hypertension was made based on CBP average of two readings, separated by 2 min, taken over three different days, with results ≥140/90 mm Hg. At 1-year follow-up, target organ damage (TOD) evolution was classified as favorable or unfavorable.ResultsMean age was 57.4 years, 56.8% were men. Adjusted multivariate analysis showed that hypertensive patients with baseline SBPM <135/85 mm Hg had a more favorable evolution of left ventricular hypertrophy (LVH) (odds ratio (OR): 1.9; 95% confidence interval (CI): 1.5-2.5), high urinary albumin excretion rate (UAER) (OR: 6.9; 95% CI: 3.4-14.4), and more favorable amount of TOD evolution (OR: 1.7; 95% CI: 1.4-2.0) than those with baseline SBPM ≥135/85 mm Hg. Patients with baseline SBPM <130/80 mm Hg, or <125/80 mm Hg had a more favorable evolution of the amount of TOD (OR: 2.7; 95% CI: 2.0-3.6, and OR: 2.9; 95% CI: 2.1-4.1, respectively) at 1 year than those with baseline SBPM <135/85 mm Hg.ConclusionsBaseline SBPM values <130/80 mm Hg is associated with better evolution of amount of TOD than SBPM values <135/85 mm Hg. These results would support a clinical trial to test a SBPM threshold <130/80 as an optimal pressure not needing pharmacological treatment among those with CBP ≥140/90.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.126American Journal of Hypertension (2012); doi:10.1038/ajh.2012.126.
Gabriel Coll-de-Tuero; Marc Saez; Carmen Roca-Saumell; Antonio Rodriguez-Poncelas; Pilar Franco; Antoni Dalfó; Laia Calvó-Perxas; Antonio Pose-Reino; Joan Bayó-Llibre
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-23
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1] Research Unit, Healthcare Institute, Girona, Spain [2] CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain [3] Department of Medical Sciences, University of Girona, Girona, Spain.
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