Blood Pressure Variability as an Independent Predictor of Early Cardiac, Renal, and Retinal Target Organ Damage in Adults with Essential Hypertension
BP Variability as a Predictor of Organ Damage
DOI:
https://doi.org/10.69750/dmls.03.05.0210Keywords:
hypertensive retinopathy, albuminuria, ambulatory blood pressure monitoring, blood pressure variability, essential hypertension, target organ damageAbstract
Background: during the day may impose additional haemodynamic stress and contribute to subclinical organ injury. Evidence linking short-term blood pressure variability with simultaneous cardiac, renal, and retinal involvement remains limited.
Objective: To determine whether increased 24-hour systolic blood pressure variability is independently associated with early cardiac, renal, and retinal target-organ damage among adults with essential hypertension.
Methods: This analytical cross-sectional study enrolled 70 adults with essential hypertension at Frontier Medical College, Abbottabad, between February 2025 and January 2026. Participants underwent 24-hour ambulatory blood pressure monitoring, transthoracic echocardiography, urinary albumin-to-creatinine ratio measurement, estimated glomerular filtration rate calculation, and dilated fundus examination. Twenty-four-hour systolic average real variability was used as the principal variability measure. Multivariable logistic regression accounted for age, sex, hypertension duration, mean 24-hour systolic pressure, and nocturnal dipping pattern.
Results: Participants had a mean age of 51.5 ± 8.9 years, and 38 (54.3%) were men. Early target-organ damage was identified in 35 (50.0%) participants. Cardiac, renal, and retinal involvement occurred in 25 (35.7%), 20 (28.6%), and 16 (22.9%) individuals, respectively. Any organ damage was more frequent in the high-variability group than in the low-variability group (68.6% vs 31.4%; p=0.002). Higher systolic variability independently predicted cardiac, renal, retinal, composite, and multiorgan involvement. Its discriminatory performance for composite damage yielded an area under the curve of 0.76.
Conclusion: Greater short-term systolic blood pressure variability was independently related to early multiorgan injury. Incorporating variability indices into ambulatory monitoring may provide additional risk information beyond mean blood pressure alone.
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