OBJECTIVE

To investigate the relationship between blood pressure variability (BPV)and target-organ damage in elderly patients with hypertension.

METHODS

A total of 197 elderly patients were included in the study. The participants were divided into two groups: those with hypertension (n=146) and those without hypertension (Control, n=51). The 24 h systolic and diastolic blood pressure variability (24 h SBPV/DBPV),24 h average systolic and diastolic blood pressure (24 h SBP/DBP), day time systolic and diastolic blood pressure variability (d SBPV/DBPV),and night time systolic and diastolic blood pressure variability (n SBPV/DBPV)were measured. The hypertensive group was further divided into low and high variability groups according to the 50th percentile of 24 h SBPV. The carotid artery intima-media thickness (IMT), left ventricular mass index (LVMI), 24 h microalbuminuria (MA) and basic clinical and laboratory parameters were compared among the groups. The correlations between blood pressure variability and IMT, LVMI, and MA were analyzed with multivariable regression analyses.

RESULTS

The patients with essential hypertension had significantly higher 24 h SBPV (P < 0.001) and d SBPV (P < 0.05) than those without hypertension. The patients with higher blood pressure variability had greater incidence of plaque and cardiovascular disorder, as well as IMT, LVMI and MA (P < 0.001). The prevalence of diabetes mellitus (DM) differed significantly among the three groups of participants (P < 0.05). The multivariable regression analysis showed that 24 h SBPV was independently correlated with IMT, LVMI and MA.

CONCLUSION

Elderly patients with hypertension have high BPV, which is an important independent predictor of target-organ damage.