Predictive Factors for Target Organ Injuries in Hypertensive Individuals

Abstract

Background

The causal relationship between systemic arterial hypertension and target organ damage (TOD) is well known, as well as the association with cardiovascular risk factors (CV). Ambulatory blood pressure monitoring (ABPM) is important in monitoring hypertension and assessing the risk of TOD.

Objective

To evaluate the relationship between blood pressure (BP) and clinical and biochemical parameters in the development of TOD in hypertensive patients.

Methods

This was a retrospective cohort study with 162 hypertensive patients followed for an average period of 13 years. The TOD investigated were left ventricular hypertrophy (LVH), microalbuminuria, coronary artery disease (CAD) and stroke. Blood pressure was assessed by ABPM and LVH using echocardiogram and electrocardiogram, respectively. Biochemical-metabolic tests and 24-hour microalbuminuria were performed at baseline and follow-up. The P-value <0.05 was considered significant.

Results

The average age was 69±11.8 years, with a predominance of women (64.8%), white ethnicity (79.6%) and diabetics (78.4%). ABPM showed a significant reduction in BP values during follow-up, although without association with TOD (microalbuminuria, stroke, and CAD), except for LVH that showed a correlation with sleep BP ≥120/70 mmHg (P=0.044). The most frequent TODs were LVH (29.6%), microalbuminuria (26.5%), CAD (19.8%) and stroke (17.3%). In the follow-up, there was an association between LVH and diabetes; microalbuminuria was associated with diabetes and triglycerides; stroke was associated with HDL-cholesterol (HDL-c), microalbuminuria and carotid disease. CAD showed a relationship with age and HDL-c.

Conclusion

Predictive factors for TOD are age, microalbuminuria, diabetes, HDL-c, triglycerides and carotid disease. Nocturnal BP is correlated with LVH. The absence of a relationship between ABPM and other TODs can be explained by the use of effective drugs, improvement of metabolic and blood pressure parameters.

Keywords:

• arterial hypertension
• ambulatory blood pressure monitoring
• left ventricular hypertrophy
• albuminuria
• stroke
• coronary artery disease

Consent Statement

Approval was obtained from the Research Ethics Committee of the State Medical School at Sao Jose do Rio Preto (FAMERP) according to national and international guidelines. The consent to review the medical records was not required by the ethics committee of the institution, because the committee waives it in cases of the retrospective nature of the research. The authors declare that this research complies with the privacy of the participants, with the data maintained anonymous and confidential. The current study was performed according to the ethical standards of the Helsinki Declaration.

Academic Link

This study is part of the Master’s thesis by Landim MP.

Acknowledgments

The authors wish to thank the reviewer for correcting both spelling and grammar of the English text.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The present study had no external funding sources.