Twenty-four-hour ambulatory heart rate and organ damage in primary hypertension

Figures & data

Table I. Baseline characteristics.

Age (years)	59.9±14.2
Female (%)	44.2
Abdominal circumference (cm) (SD)	97.5±18.9
Smokers (%)	14.7
BMI (kg/m^2) (SD)	29.4±5.1
TOD (%)	12.4
History of CV disease (%)	12.7
Hyperlipidemia (%)	62.2
Diabetes (%)	18.4
High or very high risk (%)	40.5
Age >60 years (%)	54.6
Nocturnal HR ≥65 beats/min (%)	41.3
Abnormal circadian pattern (%)	65.1
Mean SBP ABPM (mmHg) (SD)	126.9±15.4
Mean DBP ABPM (mmHg) (SD)	74.7± 11.7
HR ABPM (mmHg) (SD)	70.5±10.2
Mean of antihypertension drugs (SD)	1.24±1.2
Diuretics (%)	29.9
Beta-blockers (%)	17.7
Calcium antagonists (%)	15.5
ACE inhibitors (%)	15.5
ARBs (%)	36.6

BMI, body mass index; TOD, target organ damage; SBP, systolic blood pressure; ABPM, 24-h ambulatory blood pressure monitoring; DBP, diastolic blood pressure; HR, heart rate; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; SD, standard deviation.

Figure 1. Reasons to perform 24-h ambulatory blood pressure monitoring (ABPM). EFT, efficacy of anti-hypertensive treatment; WCH, suspected white coat hypertension; SCP, study of circadian profile assessment; HRP, high-risk patient; HBV, high BP variability; RHT, refractory hypertension.

Table II. Differential characteristics based on the presence of target organ damage (TOD).

	TOD (n=69)	No TOD (n=497)	p
Mean age (SD)	62.4 (11.5)	59.6 (14.5)	0.008
Female (%)	34.3	45.6	0.048
Abdominal circumference (cm) (SD)	98.1 (12.9)	97.4 (19.6)	ns
BMI (kg/m^2) (SD)	29.7 (6.2)	29.2 (9.9)	ns
Diabetes mellitus (%)	32.9	16.3	<0.001
Smokers (%)	22.9	13.5	0.047
History of CV disease (%)	41.4	8.7	<0.001
Family history of CV disease (%)	25.7	9.9	0.001
Hyperlipidemia (%)	54.3	35.5	0.004
Abnormal circadian pattern (%)	68.6	64.6	ns
High or very high CV risk (%)	88.6	33.7	<0.001
Mean SBP ABPM (mmHg) (SD)	146.9 (15.6)	148.0 (18.8)	ns
Mean DBP ABPM (mmHg) (SD)	84.2 (10.8)	86.6 (10.9)	ns
Mean HR in activity period (mmHg) (SD)	74.4 (10.8)	72.6 (10.9)	ns
Mean HR in resting period (mmHg) (SD)	65.4 (9.5)	62.9 (9.7)	ns
Mean HR at rest ≥65 beats/min (%)	57.1	39.0	0.006
Creatinine (mg/dl) (SD)	1.19 (0.56)	1.01 (0.17)	ns
GFR (ml/min/1.73 m^2) (SD)	68.05 (22.1)	67.47 (21.9)	ns
Number of antihypertensive drugs (SD)	1.26 (0.9)	1.20 (1.0)	ns
Diuretics (%)	44.3	27.8	0.008
Beta-blockers (%)	21.4	17.1	ns
Calcium antagonists (%)	21.4	14.7	ns
ACE inhibitors (%)	32.9	13.1	<0.001
ARBs (%)	51.4	34.5	0.008

BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HR, heart rate; GFR, glomerular filtration rate; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; SD, standard deviation.

Figure 2. Receiver operating characteristic curve (ROC) for the presence of target organ damage (TOD). Threshold nocturnal heart rate (HR). AUC, area under curve.

Table III. Differential characteristics based on the presence of heart rate (HR) at rest >65 beats/min.

	HR≥65 (n=234)	HR<65 (n=332)	p
Mean age (SD)	60.0 (15.0)	59.9 (13.7)	ns
Female (%)	50.0	40.0	0.012
Abdominal circumference (cm) (SD)	99.7 (24.0)	95.6 (13.5)	ns
BMI (kg/m^2) (SD)	29.9 (4.9)	28.9 (4.9)	ns
Diabetes mellitus (%)	19.4	17.9	ns
Smokers (%)	15.9	13.6	ns
History of CV disease (%)	13.8	12.2	ns
Family history of CV disease (%)	13.4	10.7	ns
Hyperlipidemia (%)	35.3	39.7	ns
Renal disfunction (%)	5.2	1.2	0.006
TOD (%)	17.2	9.1	0.003
Abnormal circadian pattern (%)	68.6	64.6	ns
High or very high CV risk (%)	45.3	37.3	0.035
Mean SBP (mmHg) (SD)	148.5 (19.4)	147.4 (17.8)	ns
Mean DBP (mmHg) (SD)	88.1 (11.6)	84.9 (10.1)	ns
Creatinine (mg/dl) (SD)	1.02 (0.26)	1.03 (0.22)	ns
GFR (ml/min/1.73 m^2) (SD)	67.3 (20.1)	65.7 (22.9)	ns
Number of antihypertensive drugs (SD)	1.28 (1.2)	1.21 (1.2)	ns
Diuretics (%)	31.0	29.1	ns
Beta-blockers (%)	12.9	20.9	0.009
Calcium antagonists (%)	17.2	14.2	ns
ACE inhibitors (%)	16.8	14.2	ns
ARBs (%)	39.7	34.2	ns

BMI, body mass index; TOD, target organ damage; SBP, systolic blood pressure; DBP, diastolic blood pressure; GFR, glomerular filtration rate; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; SD, standard deviation.

Table IV. Factors associated with the presence of target organ damage (TOD) in a logistic regression analysis.

Variable	OR (95% CI)	p
Diabetes mellitus (yes vs no)	1.99 (1.08–3.68)	0.027
HR at rest ≥65 beats/min (yes vs no)	2.41 (1.41–4.11)	0.001
Dislipidemia (yes vs no)	1.96 (1.13–3.39)	0.017
Gender (female vs male)	0.51 (0.28–0.89)	0.020

Other variables in the model were: age (>18 year), smoking (yes vs no), use of beta-blockers (yes vs no), angiotensin-converting enzyme inhibitors or angiotensin receptor blocker s (yes vs no).