Subclinical Target Organ Damage Research Articles

Circulating CTRP1 Levels Are Increased and Associated with the STOD in Essential Hypertension in Chinese Patients.

This study aimed to investigate the correlation between complement C1q tumor necrosis factor-related protein 1 (CTRP1) and subclinical target organ damage (STOD) in essential hypertension (EH). 720 patients were enrolled in this study, including 360 healthy subjects and 360 patients with EH. The EH group included 183 patients complicated with STOD and 177 patients without STOD. In the STOD group, there were 87 patients with left ventricular hypertrophy (LVH), 32 patients with microalbuminuria (MAU), and 58 patients with complication of LVH and MAU. Enzyme-linked immunosorbent assay (ELISA) was used to detect the CTRP1, adiponectin (APN), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). We found that CTRP1 levels were higher in patients with EH than those in healthy subjects; moreover, the level of CTRP1 of patients in the group complicated with EH and STOD was increased compared with EH patients without STOD. CTRP1 levels in the group complicated with LVH and MAU were significantly higher than those in the LVH group and the MAU group. Furthermore, APN, CTRP1, and IL-6 were three factors that influenced the STOD of EH patients, among which CTRP1 and IL6 were positively related with the complication of hypertension and STOD. In conclusion, CTRP1 levels are increased and associated with the STOD (heart and kidney) in essential hypertension, which can be regarded as a novel biomarker in the prediction of prognosis for patients with essential hypertension.

Measurement of arterial stiffness and vascular aging in community pharmacies-The ASINPHAR@2action project.

The ASINPHAR@2action project aims at raising awareness to arterial stiffness (AS) and early vascular aging (EVA) through a community pharmacy-based intervention. This preliminary analysis is focused on the analysis of the proportion of participants with increased AS and the identification of its main determinants. We performed an observational cross-sectional study of participants enrolled in 11 community pharmacies in Portugal, between April and November 2017. Blood pressure (BP) and arterial function parameters were measured with a validated device. Clinical and demographic information was gathered, as well as the estimation of global cardiovascular risk, health-related quality of life, and dietary profile. Cholesterol and glycaemia were taken from a recent laboratory bulletin. The cohort includes 658 participants with a mean age of 57.3±16.3years, 66% women. Brachial BP was 126.6±16.4mmHg and 79.9±11.5mmHg, and central BP was 115.8±15.4mmHg and 81.2±11.6mmHg, respectively, for systolic and diastolic BP. Mean pulse wave velocity (PWV) was 8.5±2.3m/s, and the augmentation index was 23.6±15.6%. The proportion of participants with increased AS was 19.8%. The overall best-fitting model for AS included age, gender, aortic PP, visceral fat, HDL cholesterol, AIx@75, total vascular resistance, hypertension, and diabetes, corresponding to an AUC of 0.910 (CI: 0.883, 0.937; P<0.001) in the ROC curve analysis. The preliminary results of this pioneering large-scale study measuring arterial function in community pharmacies provide the grounds for the operationalization of subclinical target organ damage screening in pharmacies, as a strategy to improve cardiovascular risk monitoring and to promote adherence to treatment.

The association between orthostatic blood pressure changes and subclinical target organ damage in subjects over 60 years old.

BackgroundAlthough recent studies have indicated that both orthostatic hypotension and orthostatic hypertension independently predict cardiovascular events, the underlying mechanisms are still controversial. The aim of the study was to investigate the relationships between orthostatic changes and organ damage in subjects over 60 years old.MethodsThis is a prospective observational cohort study. One thousand nine hundred and ninety-seven subjects over 60 years old were enrolled. Participants were grouped according to whether they had a drop ≥ 20 mmHg in systolic or ≥ 10 mmHg in diastolic BP (orthostatic hypotension), an increase in mean orthostatic systolic blood pressure ≥ 20 mm Hg (orthostatic hypertension), or normal changes within 3 min of orthostatism. Multiple regression modeling was used to investigate the relationship between orthostatic hypotension, orthostatic hypertension and subclinical organ damage with adjustment for confounders.ResultsOrthostatic hypotension and orthostatic hypertension were found in 461 (23.1%) and 189 (9.5%) participants, respectively. Measurement of carotid intima-media thickness (IMT), brachial-ankle pulse wave velocity (baPWV), clearance of creatinine, and microalbuminuria were associated with orthostatic hypotension; measurement of IMT and baPWV were associated with orthostatic hypertension in a cruse model. After adjustment, IMT [odds ratio (OR), 95% confidence interval (CI) per one-SD increment: 1.385, 1.052–1.823; P = 0.02], baPWV (OR = 1.627, 95% CI: 1.041–2.544; P = 0.033) and microalbuminuria (OR = 1.401, 95% CI: 1.002–1.958; P = 0.049) were still associated with orthostatic hypotension, while orthostatic hypertension was only associated with IMT (OR = 1.730, 95% CI: 1.143–2.618; P = 0.009).ConclusionsOrthostatic hypotension seems to be independently correlated with increased carotid atherosclerosis, arterial stiffness and renal damage in subjects over 60 years old. Orthostatic hypertension correlates with carotid atherosclerosis only.

High Burden of Subclinical Cardiovascular Target Organ Damage After Pediatric Liver Transplantation.

Cardiovascular (CV) events account for 8%-13% of deaths after liver transplantation (LT) in adulthood. Although CV risk factors (RFs) are present, little is known about the prevalence of subclinical CV target organ damage (TOD) in children after LT. The aim of this prospective observational study was to assess the prevalence of subclinical CV TOD in children after LT and to identify RFs contributing to CV damage as potential targets for clinical intervention. In this study, 104 children after LT (54% female, 46% male; aged 11.5±3.8years) underwent cross-sectional assessment of subclinical TOD by carotid-femoral pulse wave velocity (PWV), carotid intima-media thickness (IMT), and left ventricular mass index (LVMI). Results were correlated with the presence of CV RFs (obesity, hypertension, dyslipidemia, renal impairment, anemia, and microinflammation). Of the patients, 22% were exposed to 2 CV RFs, and 36% displayed 3 or more CV RFs. Pathological results for PWV, IMT, and LVMI were found in 21.9%, 57.0%, and 11.1% of patients, respectively. In the multivariate analysis, diastolic blood pressure (P=0.01) and estimated glomerular filtration rate (eGFR; P=0.03) were independently associated with PWV, eGFR (P=0.005), and age at LT (P=0.048) with IMT and body mass index with LVMI (P=0.004). In conclusion, patients after pediatric LT carry a substantial burden of subclinical CV TOD. Identification of modifiable CV RFs opens opportunities for targeted intervention in order to reduce CV morbidity and mortality in the future.

Aortic-flow propagation velocity is associated with proteinuria and left ventricular hypertrophy in newly diagnosed hypertensive patients.

Subclinical target organ damage (TOD) is an important long-term complication of hypertension and is associated with cardiovascular events and death. Aortic-flow propagation velocity (APV) is one of the arterial stiffness parameters. The aim of this study was to investigate the predictive value of APV on left ventricular hypertrophy (LVH) and proteinuria. A total of 149 newly diagnosed HT patients were included in the study. Urine samples and blood tests were obtained from each patient for diagnosis of proteinuria. All patients underwent echocardiographic examination. All patients' APV measurements, carotid intima-media thicknesses (CIMT), and ankle-brachial indexes (ABI) were measured and recorded. The LVH (+) group consisted of 47 patients, and the LVH (-) group consisted of 102 patients. The proteinuria (+) group consisted of 32 patients, and the proteinuria (-) group consisted of 117 patients. Average CIMT was significantly higher in both proteinuria (+) and LVH (+) groups compared with the (-) groups. ABI and APV were significantly lower in both proteinuria (+) and LVH (+) groups compared with the (-) groups. APV was negatively correlated with LVH, proteinuria, and CIMT and positively correlated with ABI. In the multivariate binary logistic regression analysis, APV was the significant independent predictor of proteinuria. Additionally, APV and ABI were found to be independent predictors of LVH or/and proteinuria. Hypertensive patients who had TOD had worse consequences of APV, CIMT, and ABI. APV had a powerful predictive value to identify the patients with higher risk of TOD among newly diagnosed hypertensive patients.

The value of ABPM and subclinical target organ damage parameters in diagnosis of resistant hypertension

IntroductionWe aimed to assess the effectiveness of ambulatory blood pressure monitoring (ABPM) and subclinical target organ damage parameters for diagnosis of resistant hypertension (RH). MethodsWe assessed demographic and anthropometric variables, the incidence of cardiovascular events and subclinical target organ damage (n=112). We also studied the relationship between these variables and the ABPM results. ResultsOf the 112 patients referred from primary care with a diagnosis of RH, 69 (61.6%) were confirmed by ABPM. We found statistically significant differences (p<0.001) between patients with RH and pseudo-resistant hypertension in the appearance of subclinical target organ damage. A percentage of 84 of the patients had microalbuminuria: 66.25±30.7mg/dl); 44.9% had stage 3 chronic kidney disease: the average glomerular filtration was 59ml/min/1.73m2; and 56.5% had left ventricular hypertrophy on echocardiography. Fundoscopy revealed that 64% of the patients had hypertensive retinopathy. Three variables were associated with an increased HR risk: microalbuminuria, hypertensive retinopathy and left ventricular hypertrophy (OR 5.7, 6.2 and 11.2, respectively). ConclusionsThis study shows that the systematic testing for target organ damage, particularly in terms of albuminuria, is a simple and inexpensive tool, with a high predictive value for RH (85%), which could be useful for prioritizing patients who need ABPM.

Prevalence of Target Organ Damage in Chinese Hypertensive Children and Adolescents

Background: Subclinical target organ damage (TOD) has been common in hypertensive children, but there is limited data in the Chinese pediatric population. This study aimed to investigate the prevalence of subclinical TOD in the Chinese hypertensive children and adolescents.Methods: A cross-sectional study was performed in children and adolescents from four schools in Jinan, China between September 2012 and September 2014. The hypertensive status was confirmed based on elevated blood pressure across three different occasions. Those with hypertension were invited to participate in the evaluation of TOD (including heart, arteries, and kidney) and metabolic disorders. A total of 7,840 children and adolescents aged 6–17 years were recruited at baseline, of whom 373 were diagnosed as hypertensive after three separate visits, and 333 (89%) participated in evaluation of TOD.Results: Among 333 hypertensive children, 47.4% had elevated carotid intima-media thickness, 32.4% had left ventricular hypertrophy, 29.2% had dyslipidemia, 7.6% had liver dysfunction, and 4.1% had microalbuminuria. Cardiovascular damages were more prevalent in children aged 9–14 years than the other age groups (i.e., 6–8 and 15–17 years). Girls had higher proportion of microalbuminuria than boys (8.2 vs. 2.6%). No significant sex and age differences were observed for the prevalence of other TODs. Nearly all subclinical TODs were much more prevalent in hypertensive children who were overweight and obese than those with normal weight, except microalbuminuria.Conclusions: The subclinical TOD is prevalent in Chinese hypertensive children and adolescents. Effective measures should be taken to fight against subclinical TOD.

A8629 Isolated Nocturnal Hypertension and Its Association with Subclinical Target Organ Damage in Untreated Chinese Patients

Objectives: Isolated nocturnal hypertension (HT) was termed as a condition of an elevated nighttime blood pressure in the presence of a daytime normotension. The clinical relevance of isolated nocturnal HT has not been comprehensively clarified regarding subclinical target organ damage. Methods: Consecutive untreated patients referred for ambulatory blood pressure (BP) monitoring to our Hypertension Clinic were recruited. The cutoff values for daytime and nocturnal hypertension were a BP of ≥135/85 mmHg and ≥120/70 mmHg, respectively. We measured subclinical target organ damage, including left ventricular mass index (LVMI), E/e’ ratio by echocardiography, carotid-femoral pulse wave velocity (cfPWV), urinary albumin-to-creatinine ratio (ACR) and brachial artery flow-mediated dilation (FMD). Results: The 1808 participants (mean age, 51 years; women, 52%) included 428 (23.7%) ambulatory normotensives, 252 (13.9%) with isolated daytime HT, 209 (11.6%) isolated nocturnal HT and 919 (50.8%) day-night HT. Patients with isolated nocturnal HT were younger (53.4 versus 55.0 years), more often reported as male (42.8% vs 30.2%), drinker (15.4% versus 10.5%) and smoker (15.4% versus 6.5%) compared with ambulatory normotensives. Compared with patients with ambulatory normotension, patients with isolated nocturnal HT had higher cfPWV (7.7 vs 7.5 m/s, P = 0.024), urinary ACR (0.71 vs 0.58 mg/mmol, P = 0.006) and higher E/e’ ratio (10.0 vs 9.6, P = 0.04) after multivariate adjustment. As for FMD and LVMI, no difference (P ≥ 0.23) between isolated nocturnal HT and ambulatory normotension was observed. Conclusion: Isolated nocturnal HT was associated with target organ damage. Ambulatory BP measurement may help clinicians to identify these patients with increased cardiovascular risk.

A9497 Prevalence of target organ damage in Chinese hypertensive children and adolescents

Objectives: The aim of our study was to investigate the prevalence of subclinical target organ damage (TOD) in Chinese hypertensive children and adolescents. Methods: A cross-sectional study was performed in children and adolescents from four schools in Jinan of China between September 2012 and September 2014. The hypertensive status was confirmed based on blood pressure measured on three different occasions. Those with hypertension were invited to participate in the evaluation of TOD (including heart, arteries, and kidney) and metabolic disorders. A total of 7840 children aged 6–17 years were recruited at baseline, of whom 373 were diagnosed as hypertension after three separate visits, and 333 (89%) participated in evaluation of TOD. Results: Among 333 hypertensive children, 32.4% had left ventricular hypertrophy, 47.4% had elevated carotid intima-media thickness, 7.6% had liver dysfunction, 4.1% had microalbuminuria, and 29.2% had dyslipidemia. Cardiovascular damages were more prevalent in children aged 9–14 years than the other age groups (i.e., 6–8 and 15–17 years). Girls had higher proportion of renal damages than boys (8.2% vs. 2.6%). No significant gender and age differences were observed for other indicators. Conclusion: The subclinical TOD is prevalent in Chinese hypertensive children and adolescents. Effective measures should be taken to fight against the subclinical TOD.

A5940 The relationship between intermedin and early damage of kidney caused by hypertension

Objectives: This study aims to observe the association between early target organ damage caused by hypertension and intermedin. To study the value of IMD in subclinical target organ damage caused by hypertension. Methods: 50 simple hypertension patients, 41 hypertensive patients with microalbuminuria and 40 healthy controls were enrolled in our study. We collected morning urine to check urinary albumin-creatinine ratio (UACR) in clinical laboratory of our hospital and urine neutrophil gelatinase-associated lipocalin (UNGAL) by method of enzyme-linked immunosorbent assay (ELISA). Results: Plasma IMD of Healthy control group is 97.25 ± 4.78pg/ml, Plasma IMD of simple hypertension group is 105.50 ± 7.69pg/ml, Plasma IMD in group of hypertension with microalbuminuria is 121.05 ± 6.59pg/ml. UNGAL of Healthy control group is 1.24 ± 0.51ng/ml, UNGAL of simple hypertension group is 3.15 ± 0.27ng/ml, UNGAL in group of hypertension with microalbuminuria: 3.84 ± 0.45ng/ml. Binary logistic regression analysis reveals that SBP (OR = 1.905, P = 0.023, 95% CI: 1.006–118.5), IMD (OR = 2.027, 95% CI:1.151–357), LDL (OR = 2.022, 95%CI:1.073–2.551) and cf-PWV (OR = 1.825, 95% CI:1.577–2.919) are related to the elevation of microalbuminuria. The ROC curve area that IMD forecasts microalbuminuria is 0.949, P < 0.001, 95%CI:0.907–0.991. Binary logistic stepwise regression analysis shows that SBP (OR = 1.159, P = 0.028, 95 %CI:1.016 - 123.2), IMD (OR = 1.425, P = 0.012, 95% CI:1.082 - 1.878) are related to the elevation of UNGAL. Conclusion: UNGAL elevation is earlier than that of microalbuminuria in hypertensive renal damage, that is, the tube and interstitial damage Occur before than glomerular lesion. Plasma intermedin is positively correlated with severity of early subclinical kidney damage cauesd by hypertension, it may be seen as early biomarker.

A13088 Subclinical target organ damage in elderly patients with resistant hypertension

Objectives: to study subclinical target organ damage in elderly hypertensive patients in comparison with younger hypertensive ones, which were resistant to previous therapy Methods: The study included 137 patients with 2–3 stage of arterial hypertension, which were resistant to previous therapy in average age 55.84 ± 9.95 yrs. The patients divided into 2 groups: 1st group n = 25 (≥65 yrs.) patients in average age 69.2 ± 2.56 yrs., 2nd group n = 112 (<65 yrs.) patients in average age 52.9 ± 8.47 yrs. Office blood pressure (BP) was measured by Korotkov method. Echocardiography performed to all patients with evaluating of left ventricular mass index (LVMI) and left ventricular diastolic function (LVDF). Serum creatinine was measured with biochemical assay method. Glomerular filtration rate (GFR) was estimated using CKD-EPI. Results:.: Baseline blood pressure (BP) was 163.4 ± 15.4/97.4 ± 9.1 mmHg and 159.1 ± 15.1/99.1 ± 8.7 mmHg for 1st and 2nd groups respectively without statistically differs, but pulse BP was higher in 1st group: 65.6 ± 11.3 mmHg vs. 60.0 ± 10.7 mmHg, p = 0.021. 1st group patients had higher LVMI (151.7 ± 39.5 g/m2 vs. 139.3 ± 32.2 g/m2, p = 0.098), statistically worse of LVDF (E/A 0.69 ± 0.1 vs. 0.85 ± 0.3, p = 0.009) and significantly lower GFR (58.7 ± 13.5 ml/min/1.73m2 vs. 66.6 ± 13.6 ml/min/1.73m2, p = 0.01). Conclusion: Elderly patients with resistant hypertension had higher pulse pressure, significantly reduce of left ventricular diastolic function and renal function in comparison with younger untreated hypertensive patients.

A18162 The correlation between uric acid level and subclinical target organ damage

A18162 The correlation between uric acid level and subclinical target organ damage

A3931 The Relationship between Urinary Magnesium Excretion and Subclinical Hypertensive Target Organ Damage

A3931 The Relationship between Urinary Magnesium Excretion and Subclinical Hypertensive Target Organ Damage

P6263Blood pressure variability as a predictor of subclinical target organ damage in normotensive women with past history of preeclampsia/eclampsia

P6263Blood pressure variability as a predictor of subclinical target organ damage in normotensive women with past history of preeclampsia/eclampsia

Marinobufagenin and left ventricular mass in young adults: The African-PREDICT study.

Background The endogenous steroidal inhibitor of sodium-potassium-dependent adenosine triphosphate and natriuretic hormone, marinobufagenin, plays a physiological role in ionic homeostasis. Animal models suggest that elevated marinobufagenin adversely associates with cardiac and renal, structural and functional alterations. It remains uncertain whether marinobufagenin relates to the early stages of target organ damage development, especially in young adults without cardiovascular disease. We therefore explored whether elevated 24-hour urinary marinobufagenin excretion was related to indices of subclinical target organ damage in young healthy adults. Design This cross-sectional study included 711 participants from the African-PREDICT study (black 51%, men 42%, 24.8 ± 3.02 years). Methods We assessed cardiac geometry and function by two-dimensional echocardiography and pulse wave Doppler imaging. 24-Hour urinary marinobufagenin and sodium excretion were measured, and the estimated glomerular filtration rate determined. Results Across marinobufagenin excretion quartiles, left ventricular mass ( P < 0.001), end diastolic volume ( P < 0.001), stroke volume ( P = 0.004) and sodium excretion ( P < 0.001) were higher within the fourth compared with the first quartile. Partial regression analyses indicated that left ventricular mass ( r = 0.08, P = 0.043), end diastolic volume ( r = 0.10, P = 0.010) and stroke volume ( r = 0.09, P = 0.022) were positively related to marinobufagenin excretion. In multivariate-adjusted regression analysis, left ventricular mass associated positively with marinobufagenin excretion only in the highest marinobufagenin excretion quartile (adjusted R2 = 0.20; β = 0.15; P = 0.043). This relationship between left ventricular mass and marinobufagenin excretion was evident in women (adjusted R2 = 0.06; β = 0.127; P = 0.015) but not in men (adjusted R2 = 0.06; β = 0.007; P = 0.92). Conclusions Left ventricular mass positively and independently associates with marinobufagenin excretion in young healthy adults with excessively high marinobufagenin excretion. Women may be more sensitive to the effects of marinobufagenin on early structural cardiac changes.

El valor de la MAPA y de los parámetros de lesión subclínica de órgano diana en el diagnóstico de hipertensión refractaria

IntroductionWe aimed to assess the effectiveness of ambulatory blood pressure monitoring (ABPM) and subclinical target organ damage parameters for diagnosis of resistant hypertension (RH). MethodsWe assessed demographic and anthropometric variables, the incidence of cardiovascular events and subclinical target organ damage (n=112). We also studied the relationship between these variables and the ABPM results. ResultsOf the 112 patients referred from primary care with a diagnosis of RH, 69 (61.6%) were confirmed by ABPM. We found statistically significant differences (P<.001) between patients with RH and pseudo-resistant hypertension in the appearance of subclinical target organ damage. A percentage of 84 of the patients had microalbuminuria: 66.25±30.7mg/dl); 44.9% had stage 3 chronic kidney disease: the average glomerular filtration was 59ml/min/1.73m2; and 56.5% had left ventricular hypertrophy on echocardiography. Fundoscopy revealed that 64% of the patients had hypertensive retinopathy. Three variables were associated with an increased HR risk: microalbuminuria, hypertensive retinopathy and left ventricular hypertrophy (OR 5.7, 6.2 and 11.2, respectively). ConclusionsThis study shows that the systematic testing for target organ damage, particularly in terms of albuminuria, is a simple and inexpensive tool, with a high predictive value for RH (85%), which could be useful for prioritising patients who need ABPM.

SUBCLINICAL TARGET ORGAN DAMAGE IN HYPERTENSIVE SUBJECTS INCLUDED IN THE IBERICAN STUDY

Objective:The general aim of IBERICAN study is to know the prevalence and incidence of cardiovascular risk factors and cardiovascular and renal disease in Spain. The aim of this abstract is to know the prevalence of subclinical target organ damage (TOD) in hypertensive patients respect non hypertens

ALBUMIN-TO-CREATININE RATIO AND SUBCLINICAL ORGAN DAMAGE IN HYPERTENSIVES

Objective: Hypertension is associated with higher cardiovascular risk as well as several markers of subclinical target organ damage (TOD). Albumin to creatinine ratio (ACR) in urine has been recognised as an independent risk factor for cardiovascular events. We hypothesised that there is a relationship between ACR and markers of TOD in never-treated hypertensives. Design and method: We enrolled 924 consecutive essential hypertensives (mean age 53 ± 12 years, 486 males) without known cardiovascular disease (CVD). Markers of subclinical TOD [left ventricular mass index (LVMI), pulse wave velocity (PWV), ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR)] were evaluated in all patients. LVMI was assessed echocardiographically using the Devereux formula. Carotid-femoral PWV was estimated with the Complior device. eGFR was calculated by the Cockcroft-Gault formula. Wave reflections were assessed with aortic augmentation index corrected for heart rate ([email protected]). ABI was calculated by dividing the highest ankle systolic blood pressure by the highest brachial systolic blood pressure. In a 24-hour urine collection, ACR was measured. Results: ACR exhibited significant association with LVMI (r = 0.277, p < 0.001), PWV (r = 0.123, p < 0.001), ABI (r = −0.078, p = 0.018) and eGFR (r = −0.100, p = 0.002). In further analysis, ACR was associated with TOD as suggested by the 2013 European Guidelines for Hypertension [left ventricular hypertrophy (LVMI > 115 g/m2 in men and > 95 g/m2 in women), increased PWV (PWV > 10m/s), decreased. ABI (ABI < 0.9) and decreased renal function (eGFR < 60 ml/min)]. Specifically, ACR exhibited a significant association with the number of TOD and this association was independent of age and gender (p < 0.05, Figure).Conclusions: Our findings support the close relationship between ACR and TOD in hypertension, as well as, the predictive ability of ACR for TOD.

In healthy normotensive subjects age and blood pressure better predict subclinical vascular and cardiac organ damage than atherosclerosis biomarkers

Purpose: Only few studies evaluated biomarkers useful for defining the cardiovascular risk of a subject in a pre-clinical condition (i.e. healthy subjects). In this context we sought to determine the relationships of Plasminogen activator inhibitor type 1 (PAI‐1), P-Selectin, Tissue Inhibitors Metalloproteinases type 1 (TIMP-1) and Cystatin-C with subclinical Target Organ Damage (TOD) in normotensive and normoglycemic subjects without known cardiovascular and kidney diseases.Materials and Methods: 480 blood donors participated at the present analysis. TOD was evaluated as Pulse Wave Velocity (PWV), Left Ventricular Hypertrophy (LVH) and Intima Media Thickness (IMT) and carotid plaque presence) grouped together under carotid TOD.Results: 3.1% of the subjects showed a PWV higher than 10 m/sec with those subjects exerting significantly lower values of P-Selectine (0.068 ± 0.015 vs 0.08 ± 0.036 mg/L, p = .014). 8.8% of the subjects showed carotid TOD that was associated with higher Cystatin-C values (0.67 ± 0.17 vs 0.63 ± 0.14 mg/L, p = .045). Finally 23.8% of the subjects showed LVH with no significant differences regarding biomarkers. Despite some significant correlations between biomarkers and TOD, at the multivariate analysis none came out to be as significant predictor of the assessed TOD.Conclusions: in normotensive and normoglycemic healthy subjects, the evaluated biomarkers of atherosclerotic process didn’t show any significant association with cardiac, carotid and vascular TOD while age and BP are its principal predictors.

There is a significant relationship between morning blood pressure surge and increased abdominal aortic intima-media thickness in hypertensive patients.

There are limited data about increased aortic intima-media thickness (A-IMT) in the presence of subclinical target organ damage in hypertensive (HT) patients. In this study, we aimed to determine the frequency of increased A-IMT, the parameters determining increased A-IMT, and the relationship between increased A-IMT and other vascular IMT measurements. We prospectively included 265 patients (mean age 54.1 ± 10.6years, male/female 91/174) with essential HT. Physical examination of all patients was performed. Laboratory data and antihypertensive treatments were recorded. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) was performed. Bilateral carotid, brachial, and femoral artery and abdominal A-IMT values were measured by B-mode ultrasonography (USG). Patients were categorized into two main groups: patients with increased A-IMT (≥ 3mm) or normal A-IMT (< 3mm). Increased A-IMT was detected in 55 patients (20.8%). There was a close relationship between increased A-IMT and advanced age, presence of coronary artery disease, high morning blood pressure surge (MBPS), and bilateral carotid and femoral IMT. Parameters associated with increased A-IMT in univariate analysis were assessed by regression analysis. Left femoral IMT and MBPS were independently associated with increased A-IMT. In the regression model, each 5-mmHg elevation in MBPS increased the risk of increased A-IMT by 34.2%. The cutoff value of MBPS obtained by the ROC curve analysis was 32mmHg for the prediction of increased A-IMT (sensitivity 76.3%, specificity 63.5%). The area under the curve was 0.784 (95% CI 0.720-0.847, p < 0.001). Abdominal A-IMT increased at a significant rate in patients with HT. An independent association was found between MBPS and A-IMT, which can both be easily detected by ABPM and B-mode USG. The high MBPS level was considered to be a simple and inexpensive method for detecting subclinical target organ damage. A-IMT measurement should also be a part of abdominal USG, which is a routine examination in HT patients.