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Home blood pressure is the predictor of subclinical target organ damage like ambulatory blood pressure monitoring in untreated hypertensive patients [Anatol J Cardiol]
Anatol J Cardiol. 2014; 14(8): 711-718 | DOI: 10.5152/akd.2014.5119  

Home blood pressure is the predictor of subclinical target organ damage like ambulatory blood pressure monitoring in untreated hypertensive patients

Ae-Young Her1, Yong Hoon Kim1, Se-Joong Rim2, Jong-Youn Kim2, Eui-Young Choi2, Pil-Ki Min2, Byoung-Kwon Lee2, Bum-Kee Hong2, Hyuck Moon Kwon2
1Division of Cardiology, Department of Internal Medicine, School of Medicine, Kangwon National University; Chuncheon-Republic of Korea
2Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul-Republic of Korea

Objective: Home blood pressure (HBP) measurements are known as an important adjunct to office blood pressure (OBP) measurements in clinical practice. But little is known about the relationship between HBP and subclinical target organ damage (TOD) other than left ventricular hypertrophy (LVH). So we investigated the relationship of HBP measurements with subclinical TOD in untreated hypertensive patients. Methods: We measured ambulatory blood pressure (ABP), HBP and OBP of 93 untreated hypertensive patients (men: 60 and women: 33, mean age, 49±13 years). The ABP was recorded for 24 hours, HBP was measured for one week, and OBP was measured at least in two visits. All BP measurements were taken using automatic BP measuring device. The parameters indicating subclinical TOD were the left-ventricular mass index (LVMI) by transthoracic echocardiography, urinary albumin excretion rate (AER), brachial ankle pulse-wave velocity (PWV), and carotid intima-media thickness (IMT). Results: The LVMI was significantly correlated with systolic HBP and 24 hours systolic ABP, but not with OBP. The AER, PWV and IMT were also significantly correlated with systolic HBP and 24 hours systolic ABP. In a binary logistic regression analysis, systolic HBP, 24 hours systolic and diastolic ABP were the predictors of LVMI, AER and PWV (all p<0.05). Conclusion: Our data suggest that HBP is as good as ABP monitoring and superior to OBP measurements in regard to their association with subclinical TOD. Therefore, HBP measurements give valuable information on the subclinical TOD in hypertensive patients in addition to ABP monitoring.

Keywords: home blood pressure, ambulatory blood pressure, target organ damage


Evde kan basıncı ölçümü, subklinik hedef organ hasarının belirleyicisidir

Ae-Young Her1, Yong Hoon Kim1, Se-Joong Rim2, Jong-Youn Kim2, Eui-Young Choi2, Pil-Ki Min2, Byoung-Kwon Lee2, Bum-Kee Hong2, Hyuck Moon Kwon2
1Division of Cardiology, Department of Internal Medicine, School of Medicine, Kangwon National University; Chuncheon-Republic of Korea
2Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul-Republic of Korea

Amaç: Evde kan basıncı (EKB) ölçümleri, klinik pratikte ofis kan basıncı (OKB) ölçümleri için önemli bir yardımcı olarak bilinir.Ama EKB ve subklinik hedef organ hasarı (HOH) arasındaki ilişki, sol ventrikül hipertrofisi (SVH) dışında daha az bilinmektedir.Bu yüzden biz, tedavi edilmemiş hipertansif hastalarda subklinik HOH ile EKB ölçümlerinin arasındaki ilişkiyi araştırdık. Metod: Ambulatuvar kan basıncını (AKB), EKB ve OKB'yi 93 tedavi edilmemiş hipertansif hastada ölçtük (erkek 60 ve kadın 33, ortalama 49±13 yaş). AKB 24 saat süre ile kaydedildi, EKB bir hafta boyunca ölçüldü ve OKB en az iki ziyaretle ölçülmüştür. Tüm kan basıncı (KB) ölçümleri otomatik KB ölçüm cihazı kullanılarak yapılmıştır. Subklinik HOH gösteren parametreler; transtorasik ekokardiyografi ile sol ventrikül kitle indeksi (SVKİ), üriner albumin atılım hızı (AAH), brakiyal-ayak bileği nabız-dalga hızı (NDH) ve karotis intima-media kalınlığıydı (İMK). Bulgular: SVKİ, sistolik OKB ve 24 saat sistolik AKB ile paraleldi, fakat OKB ile paralel değildi. AAH, nabız dalga hızı ve İMK de sistolik EKB ve 24 saat sistolik AKB ile belirgin korelasyon gösteriyordu. İkili lojistik regresyon analizinde; 24 saat sistolik ve diyastolik ABP ve sistolik EKB SVKİ, AAH ve NDH için öngördürücü idi (p<0,05). Sonuç: Verilerimiz subklinik HOH ile ilişki açısından EKB’nin AKB monitorizasyonu kadar iyi ve OKB ölçümünden üstün olduğunu göstermektedir. Bu nedenle, EKB ölçümlerinin ABP izlenmesine ek olarak, hipertansif hastalarda, subklinik HOH konusunda değerli bilgiler verir.

Anahtar Kelimeler: evde ölçülen kan basıncı, ayaktan kan basıncı, organ hasarı hedefi


Ae-Young Her, Yong Hoon Kim, Se-Joong Rim, Jong-Youn Kim, Eui-Young Choi, Pil-Ki Min, Byoung-Kwon Lee, Bum-Kee Hong, Hyuck Moon Kwon. Home blood pressure is the predictor of subclinical target organ damage like ambulatory blood pressure monitoring in untreated hypertensive patients. Anatol J Cardiol. 2014; 14(8): 711-718


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