Document Detail


Prevalence and correlates of multiple organ damage in a never-treated hypertensive population: role of ambulatory blood pressure.
MedLine Citation:
PMID:  18199918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Cesare Cuspidi; Cristiana Valerio; Carla Sala; Arturo Esposito; Meilikè Masaidi; Francesca Negri; Alberto Zanchetti; Giuseppe Mancia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  13     ISSN:  1359-5237     ISO Abbreviation:  Blood Press Monit     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-17     Completed Date:  2008-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  7-13     Citation Subset:  IM    
Affiliation:
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Italy. cesare.cuspidi@unimib.it
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MeSH Terms
Descriptor/Qualifier:
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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