Short-Term 24-h Systolic Blood Pressure Variability and Subclinical Target-Organ Damage in White-Coat Hypertension: A Retrospective Cross-Sectional Study.

IF 3.2 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Health and Risk Management Pub Date : 2026-09-16 eCollection Date: 2026-01-01 DOI:10.2147/VHRM.S626042

Jing Huang, Zien Huang, Feng Huang

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引用次数: 0

Abstract

Objective: To compare subclinical target-organ damage (TOD) across normotension (NT), white-coat hypertension (WCH), and mild-to-moderate hypertension (HT), and examine the association of 24-h systolic blood pressure (SBP) variability with concurrent TOD in untreated WCH.

Methods: This single-center retrospective cross-sectional study included 267 hospitalized participants who underwent ambulatory blood pressure monitoring between 2012 and 2021 (91 NT, 93 WCH, 83 HT). TOD markers were compared across groups. Within WCH, multivariable models assessed 24-h SBP variability in relation to any TOD, left ventricular hypertrophy (LVH), left ventricular mass index (LVMI), and microalbuminuria (MA), adjusting for age, sex, body mass index, and 24-h mean SBP.

Results: Any TOD occurred in 26.4%, 52.7%, and 71.1% of NT, WCH, and HT participants, respectively (P<0.001). Within WCH, any TOD occurred in 35.5%, 64.5%, and 58.1% across increasing variability tertiles; the unadjusted between-tertile comparison was not statistically significant (P=0.056). Continuous 24-h SBP variability was associated with any TOD (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.05-1.52), LVH (OR 1.30, 95% CI 1.08-1.60), LVMI (β=2.23 g/m², 95% CI 0.33-4.12), and log-transformed MA (β=0.105, 95% CI 0.052-0.157). The area under the receiver operating characteristic curve was 0.613 for the base model and 0.678 after adding 24-h SBP variability, with better overall fit of the extended model (likelihood-ratio P=0.009).

Conclusion: WCH showed an intermediate prevalence of any TOD between NT and mild-to-moderate HT. Within WCH, higher 24-h SBP variability was associated with concurrent TOD after accounting for 24-h mean SBP and basic clinical factors, and may provide Supplementary Information when interpreted alongside mean ambulatory blood pressure. These single-center cross-sectional findings do not establish temporal or causal relationships and require confirmation in prospective multicenter studies.

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白大褂高血压患者短期24小时收缩压变异性和亚临床靶器官损害：一项回顾性横断面研究。

目的：比较正常血压（NT）、白大衣高血压（WCH）和轻中度高血压（HT）患者的亚临床靶器官损伤（TOD），并探讨未治疗的WCH患者24小时收缩压（SBP）变异性与同期TOD的关系。方法：这项单中心回顾性横断面研究纳入了267名住院参与者，他们在2012年至2021年间接受了动态血压监测（NT 91例，WCH 93例，HT 83例）。各组间比较TOD指标。在WCH中，多变量模型评估了与TOD、左室肥厚（LVH）、左室质量指数（LVMI）和微量白蛋白尿（MA）相关的24小时收缩压变异性，并对年龄、性别、体重指数和24小时平均收缩压进行了调整。结果：在NT、WCH和HT参与者中，TOD发生率分别为26.4%、52.7%和71.1% (P2, 95% CI 0.33-4.12)，对数转换MA （β=0.105, 95% CI 0.052-0.157）。基本模型的受试者工作特征曲线下面积为0.613，加入24 h收缩压变异性后的受试者工作特征曲线下面积为0.678，扩展模型的整体拟合效果较好（似然比P=0.009）。结论：WCH显示任何TOD的发生率介于NT和轻至中度HT之间。在WCH中，考虑到24小时平均收缩压和基本临床因素后，较高的24小时收缩压变异性与并发TOD相关，当与平均动态血压一起解释时，可能提供补充信息。这些单中心横断面研究结果不能建立时间或因果关系，需要在前瞻性多中心研究中得到证实。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.