The effect of blood pressure variability as a cardiovascular risk factor on target organ damage in elderly

Written by Magdás Annamária, Belényi Boglárka, Incze Sándor

Introduction: The prevalence of hypertension increases with age. Hypertension in the elderly population is characterized by high variability, but its clinical significance is not yet fully understood. Our goal was to assess circadian blood pressure variability (BPV) in elderly patients with new parameters and to determine its relationship to target organ damage. Material and methods: 63 hypertensive patients were included in the study, 36 elderly, aged over 60 years (13 male, 23 female, age 71,13±7,8 years) and 27 (14 male, 13 female, age 49,5±8,4 years) patients younger than 60 years. After 24-hour ambulatory blood pressure monitoring (ABPM), awake, asleep and 24 hour blood pressure values, pulse pressure (PP) -as an indicator of arterial stiffness and left ventricular mass index (LVMI) - quantified by 2D echocardiography were compared between the groups. Based on ABPM values, BPV was calculated using a new index, according to formula of read-to-read average real variability (ARV). We assessed the relationship between blood pressure variability and pulse pressure, and left ventricular mass index respectively in both groups. Results: LVMI was significantly higher in the elderly group, 124.5 ± 26.9 g/m2, comparing to the younger group, 109.7 ± 36 g/ m2 (p=0.05). Statistically significant correlation was found in elderly between nighttime BPV and LVMI (p=0.0002), and PP (p=0,02). High 24-hour systolic blood pressure variability correlates with higher LVMI (p=0.01), and higher PP (p=0.04) in the elderly. Conclusions: Higher BPV in elderly promotes target organ damage. BPV is an independent cardiovascular risk factor. Antihypertensive therapy should focus also on reducing 24-hour BP variability.


Keywords: blood pressure, variability, target organ damage

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