PP.38.02

Abstract

Objective: This study compared home (HBP), ambulatory (ABP) and clinic (CBP) blood pressure (BP) in terms of their association with preclinical organ damage in young individuals. Design and method: Apparently healthy children, adolescents and young adults referred for elevated BP and healthy volunteers (age 6–26 years) were subjected to: (i) CBP (1 visit), HBP (7 days) and ABP (24-h) measurements, (ii) echocardiographic determination of left ventricular mass index (LVMI); (iii) measurement (ultrasonography) of the common carotid intima-media thickness (IMT), (iv) measurement of pulse wave velocity (PWV). Results: A total of 139 young individuals (mean age 13.9 ± 3.7 years; age range: 6–25, 96 boys) were analyzed (129 had measurements of LVMI, 94 PWV and 58 IMT). Average CBP was 124.8 ± 17/70.7 ± 11.5 mmHg (systolic/diastolic), HBP 122.3 ± 12.4/70.2 ± 7.3 mmHg and 24-h ABP 121.5 ± 11.9/68.3 ± 6.7 mmHg. LVMI was correlated with systolic BP (coefficient r = 0.38/0.34/0.38 for 24-h/daytime/nighttime ABP, 0.29 for HBP and 0.32 for CBP; all p < 0.01). PWV was significantly correlated with systolic BP (r = 0.40/0.39/0.37 for 24-h/daytime/nighttime ABP, 0.33 for HBP and 0.52 for CBP; all p < 0.01). IMT was correlated with pulse pressure (coefficient r = 0.42/0.44/0.36 for 24-h/daytime/nighttime ABP, 0.45 for HBP and 0.42 for CBP; all p < 0.01). In multivariate stepwise regression analysis (age, gender, body mass index [BMI], systolic CBP, HBP, 24-h/daytime/nighttime ABP and pulse pressures as independent variables), LVMI was determined (R2 = 0.25) by BMI and nighttime systolic ABP, PWV (R2 = 0.27) by systolic CBP and IMT (R2 = 0.20) by home pulse pressure. Conclusions: In young individuals, HBP and ABP measurements appear to be similar and superior to the conventional CBP measurements in terms of their association with LVMI and IMT, whereas PWV appears to be determined mainly by CBP.