Target organ complications and prognostic significance of alerting reaction: analysis from the Dallas heart study

Alejandro Velasco, Colby Ayers, Sandeep R Das, James A de Lemos, Amit Khera, Ronald G. Victor, Norman M Kaplan, Wanpen Vongpatanasin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE:: Noninvasive blood pressure (BP) measurement often triggers a transient rise in BP, known as an alerting reaction. However, the prevalence and prognostic significance of the alerting reaction has never been assessed in the general population. METHODS:: We evaluated the association between the alerting reaction and left ventricular mass by MRI and urinary albumin-to-creatinine ratio in the Dallas Heart Study, a large population sample of 3069 individuals. Participants were categorized into four groups based on levels of consecutive BP: first, normal first BP and average third to fifth (avg3–5) BP of less than 140/90?mmHg (control group); second, high first BP of at least 140/90?mmHg and normal (avg3–5) BP (alerting reaction group); third, normal first BP and high (avg3–5) BP; and fourth, high first to fifth BP. Then, associations between BP categories with incident cardiovascular outcomes (coronary heart disease, stroke, atrial fibrillation, heart failure, and cardiovascular death) over a median follow-up period of 9.4 years were assessed. RESULTS:: The sample-weighted prevalence of isolated hypertension during the first BP measurement was 9.6%. Presence of an alerting reaction was independently associated with increased left ventricular mass, urinary albumin-to-creatinine ratio, cardiovascular events after adjustment for traditional cardiovascular risk factors, and baseline BP (adjusted hazard ratio 1.24, 95% confidence interval 1.07–1.43). CONCLUSION:: Our study indicated that the alerting reaction is independently associated with increased cardiovascular and renal complications.

Original languageEnglish (US)
JournalJournal of Hypertension
DOIs
StateAccepted/In press - Oct 19 2015

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Blood Pressure
Hypertension
Albumins
Creatinine
Atrial Fibrillation
Population
Coronary Disease
Heart Failure
Stroke
Confidence Intervals
Kidney
Control Groups

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Target organ complications and prognostic significance of alerting reaction : analysis from the Dallas heart study. / Velasco, Alejandro; Ayers, Colby; Das, Sandeep R; de Lemos, James A; Khera, Amit; Victor, Ronald G.; Kaplan, Norman M; Vongpatanasin, Wanpen.

In: Journal of Hypertension, 19.10.2015.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE:: Noninvasive blood pressure (BP) measurement often triggers a transient rise in BP, known as an alerting reaction. However, the prevalence and prognostic significance of the alerting reaction has never been assessed in the general population. METHODS:: We evaluated the association between the alerting reaction and left ventricular mass by MRI and urinary albumin-to-creatinine ratio in the Dallas Heart Study, a large population sample of 3069 individuals. Participants were categorized into four groups based on levels of consecutive BP: first, normal first BP and average third to fifth (avg3–5) BP of less than 140/90?mmHg (control group); second, high first BP of at least 140/90?mmHg and normal (avg3–5) BP (alerting reaction group); third, normal first BP and high (avg3–5) BP; and fourth, high first to fifth BP. Then, associations between BP categories with incident cardiovascular outcomes (coronary heart disease, stroke, atrial fibrillation, heart failure, and cardiovascular death) over a median follow-up period of 9.4 years were assessed. RESULTS:: The sample-weighted prevalence of isolated hypertension during the first BP measurement was 9.6{\%}. Presence of an alerting reaction was independently associated with increased left ventricular mass, urinary albumin-to-creatinine ratio, cardiovascular events after adjustment for traditional cardiovascular risk factors, and baseline BP (adjusted hazard ratio 1.24, 95{\%} confidence interval 1.07–1.43). CONCLUSION:: Our study indicated that the alerting reaction is independently associated with increased cardiovascular and renal complications.",
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AU - Velasco, Alejandro

AU - Ayers, Colby

AU - Das, Sandeep R

AU - de Lemos, James A

AU - Khera, Amit

AU - Victor, Ronald G.

AU - Kaplan, Norman M

AU - Vongpatanasin, Wanpen

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N2 - OBJECTIVE:: Noninvasive blood pressure (BP) measurement often triggers a transient rise in BP, known as an alerting reaction. However, the prevalence and prognostic significance of the alerting reaction has never been assessed in the general population. METHODS:: We evaluated the association between the alerting reaction and left ventricular mass by MRI and urinary albumin-to-creatinine ratio in the Dallas Heart Study, a large population sample of 3069 individuals. Participants were categorized into four groups based on levels of consecutive BP: first, normal first BP and average third to fifth (avg3–5) BP of less than 140/90?mmHg (control group); second, high first BP of at least 140/90?mmHg and normal (avg3–5) BP (alerting reaction group); third, normal first BP and high (avg3–5) BP; and fourth, high first to fifth BP. Then, associations between BP categories with incident cardiovascular outcomes (coronary heart disease, stroke, atrial fibrillation, heart failure, and cardiovascular death) over a median follow-up period of 9.4 years were assessed. RESULTS:: The sample-weighted prevalence of isolated hypertension during the first BP measurement was 9.6%. Presence of an alerting reaction was independently associated with increased left ventricular mass, urinary albumin-to-creatinine ratio, cardiovascular events after adjustment for traditional cardiovascular risk factors, and baseline BP (adjusted hazard ratio 1.24, 95% confidence interval 1.07–1.43). CONCLUSION:: Our study indicated that the alerting reaction is independently associated with increased cardiovascular and renal complications.

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