| Prevalence and correlates of multiple organ damage in a never-treated hypertensive population: role of ambulatory blood pressure. | |
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MedLine Citation:
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PMID: 18199918 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Available evidence on multiple target organ damage (TOD) in the early phases of essential hypertension is scanty. We examined the prevalence and correlates of multiple TOD in never-treated patients with recently diagnosed hypertension. METHODS: A total of 602 consecutive outpatients with grades 1 and 2 hypertension underwent the following procedures: (i) routine examination, (ii) 24-h urine collection for microalbuminuria, (iii) ambulatory blood pressure monitoring over two 24-h periods within 4 weeks, (iv) echocardiography, (v) carotid ultrasonography. TOD at cardiac, vascular and renal levels was defined according to major international hypertension guidelines. RESULTS: Prevalence rates of patients negative for TOD (group I) or positive for one (group II), two (group III), or three (group IV) markers of TOD were as follows: 45, 33, 17 and 5%. In group II, alterations in left ventricular structure and geometry were more frequently present than carotid atherosclerosis and microalbuminuria; a similar trend was found in group III where a close association between cardiac and vascular, but not renal, signs of TOD was observed. In multiple regression analyses the risk of having three TOD was significantly related to age [odds ratio (OR): 2.11, 95% confidence interval (CI): 1.34-3.53], average 48-h systolic blood pressure (OR: 1.81, 95% CI: 1.22-2.95), smoking status (OR: 1.76, 95% CI: 1.22-2.86), male sex (OR: 1.36, 95% CI: 1.24-1.79), reproducible nondipping pattern (OR: 1.27, 95% CI: 1.12-1.61) and metabolic syndrome (OR: 1.16, 95% CI: 1.09-1.74). CONCLUSIONS: Our results show that: (i) a cluster of three TOD, namely at cardiac, carotid and renal levels, is not a common finding in a population of untreated essential hypertensive patients; a single TOD is present in about one-third of the patients and the parallel involvement of two organs in one-fifth of the cases; (ii) old age, ambulatory systolic blood pressure and smoking status are the most important predictors of multiple organ involvement. |
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Authors:
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Cesare Cuspidi; Cristiana Valerio; Carla Sala; Arturo Esposito; Meilikè Masaidi; Francesca Negri; Alberto Zanchetti; Giuseppe Mancia |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Blood pressure monitoring Volume: 13 ISSN: 1359-5237 ISO Abbreviation: Blood Press Monit Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-01-17 Completed Date: 2008-04-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9606438 Medline TA: Blood Press Monit Country: England |
Other Details:
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Languages: eng Pagination: 7-13 Citation Subset: IM |
Affiliation:
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Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Italy. cesare.cuspidi@unimib.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Albuminuria Blood Pressure Monitoring, Ambulatory* Carotid Artery Diseases / diagnosis, etiology Female Heart Diseases / diagnosis, etiology Humans Hypertension / complications*, epidemiology* Kidney Diseases / diagnosis, etiology Male Middle Aged Multiple Organ Failure / etiology* Odds Ratio Prevalence |
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