Blood pressure (BP) load, defined as the percentage of abnormally elevated BP readings, is provided on the report of ambulatory BP monitoring. The relationship between BP load, independently from BP level, and target organ damage (TOD) in hypertension disease is under investigation. We aimed to explore the relationship between BP load and TOD in patients with newly diagnosed essential hypertension as well as the role of dipping status.Design and method:
We studied 300 patients with newly diagnosed and never treated essential hypertension (mean age 50+11 years, 187 males, 202 dippers). We performed: a. 24 h ambulatory BP measurement (ABPM) in order to measure BP load and estimate dipping status and b. we evaluated carotid-femoral artery pulse wave velocity (PWV), carotid intima-media thickness (IMT), microalbuminouria (MAU), LV remodeling (LVMI), and coronary flow reserve (CFR).Results:
Dipper hypertensive patients (n = 202) were younger, mostly males with reduced 24 h SBP, 24 h PP, cIMT and LVMI compared to non-dippers (n = 98). In the whole hypertensive population, BP load parameters were, independently of 24 h mean BP, related with PWV (daytime and night-time SBP load) and IMT (daytime SBP load). In dipper hypertensive population, only daytime SBP load was independently of 24 h mean BP, related with PWV.Conclusions:
Daytime and night-time SBP load are independently related with PWV and IMT, respectively, in middle-aged untreated hypertensives. Our results add new data regarding the role of daytime SBP load since its independent association with PWV was evident only in dipper hypertensives.