1
|
D’Amato A, Mancusi C, Losi MA, Izzo R, Arnone MI, Canciello G, Senese S, De Luca N, de Simone G, Trimarco B. Target Organ Damage and Target Systolic Blood Pressure in Clinical Practice: The Campania Salute Network. Am J Hypertens 2018; 31:658-664. [PMID: 29566163 DOI: 10.1093/ajh/hpy007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/23/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Lowering systolic blood pressure (SBP) below the conventional threshold (140 mm Hg) reduces left ventricular (LV) hypertrophy and incident cardiovascular (CV) events. We assessed whether different thresholds of SBP as the average value during follow-up (FU) have different impact on changes in target organ damage (TOD). METHODS From the Campania Salute Network registry, we selected 4,148 hypertensive patients with average SBP-FU <140 mm Hg, and without history of prevalent CV or chronic kidney disease (i.e., <stage IV CKD). Patients were divided in "Tight" (SBP-FU <130 mm Hg) or "Usual" (SBP-FU ≥130) BP control. At baseline and at the last available control visit, we assessed LV mass index (LVMi, g/m2.7), carotid intimal-medial thickness (IMT, mm), and glomerular filtration rate by CKD-EPI equation (GFR, ml/min/1.73 m2) as markers of TOD. Time trend of TOD for tight and usual subgroups were compared, adjusting for significant confounders. RESULTS During a median of 74 months (interquartile range: 35-108 months), 1,824 patients (44%) were classified as tight control. They were younger, with less prevalent obesity, diabetes, lower initial LVMi, and IMT, and were taking less Ca++-channel blockers during FU than the usual control subgroup (all P < 0.05). In both subgroups, there were no changes over time in LVMi and GFR, whereas the IMT increased during the FU (P < 0.004), with no significant effect of degree of SBP control. CONCLUSIONS In a registry of treated hypertensive patients from a tertiary care center, progression of TODs is not related to average SBP during FU.
Collapse
Affiliation(s)
- Andrea D’Amato
- Hypertension Research Center, Federico II University, Naples, Italy
| | - Costantino Mancusi
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Maria Angela Losi
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Raffaele Izzo
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | | | - Grazia Canciello
- Hypertension Research Center, Federico II University, Naples, Italy
| | | | - Nicola De Luca
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Giovanni de Simone
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Bruno Trimarco
- Hypertension Research Center, Federico II University, Naples, Italy
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| |
Collapse
|
2
|
Mancusi C, Izzo R, de Simone G, Carlino MV, Canciello G, Stabile E, de Luca N, Trimarco B, Losi MA. Determinants of decline of renal function in treated hypertensive patients: the Campania Salute Network. Nephrol Dial Transplant 2018; 33:435-440. [DOI: 10.1093/ndt/gfx062] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Costantino Mancusi
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Raffaele Izzo
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Translational Medical Sciences, University of Naples, Federico II, Naples, Italy
| | - Giovanni de Simone
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Translational Medical Sciences, University of Naples, Federico II, Naples, Italy
| | - Maria Viviana Carlino
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Translational Medical Sciences, University of Naples, Federico II, Naples, Italy
| | - Grazia Canciello
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Translational Medical Sciences, University of Naples, Federico II, Naples, Italy
| | - Eugenio Stabile
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Nicola de Luca
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Bruno Trimarco
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| | - Maria Angela Losi
- Hypertension Research Center, University of Naples, Federico II, Naples, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Naples, Italy
| |
Collapse
|