Ambulatory blood pressure variability in prediction of target organ injury: the SHIP AHOY study.

Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD)...

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Published in:Pediatric Nephrology Vol. 41; no. 1; pp. 157 - 166
Main Authors: Hanevold, Coral D., Seo, Jang Dong, Daniels, Stephen R., Falkner, Bonita E., Ferguson, Michael A., Flynn, Joseph T., Ingelfinger, Julie R., Khoury, Philip R., Lande, Marc B., Meyers, Kevin E., Mitsnefes, Mark, Samuels, Joshua, Urbina, Elaine M.
Format: research tables/charts Journal Article
Published: Springer Nature Jan2026
Online Access:View this record in EBSCOhost
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      dt: Jan2026
      vid: 41
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-025-06803-4
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        atl: Ambulatory blood pressure variability in prediction of target organ injury: the SHIP AHOY study.
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          Hanevold, Coral D.
          Seo, Jang Dong
          Daniels, Stephen R.
          Falkner, Bonita E.
          Ferguson, Michael A.
          Flynn, Joseph T.
          Ingelfinger, Julie R.
          Khoury, Philip R.
          Lande, Marc B.
          Meyers, Kevin E.
          Mitsnefes, Mark
          Samuels, Joshua
          Urbina, Elaine M.
        affil: https://ror.org/00cvxb145 Division of Nephrology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
      sug:
        subj:
          Blood Pressure
          Heart Rate Variability
          Hypertrophy, Left Ventricular
          Ventricular Function, Left
          Blood Pressure Monitoring, Ambulatory
          Human
          Anthropometry
          Heart Rate
          Multicenter Studies
          Pulse Wave Velocity
          Adolescence
          Descriptive Statistics
          Male
          Female
          Logistic Regression
          Academic Medical Centers United States
          United States
          Sphygmomanometers
          ROC Curve
          Funding Source
          Adolescent: 13-18 years
          Male
          Female
      ab: Background: Ambulatory hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction, and increased arterial stiffness in adolescents. Whether the addition of measures of BP variability improves the prediction of subclinical cardiovascular target organ damage (TOD) over mean BP measures is not known. Methods: We assessed clinic and ambulatory BP (ABP), anthropometrics, and TOD in 397 adolescents. ABP means standard deviation (SD), BP, and heart rate (HR) dipping were calculated; coefficients of variability (CV) were calculated (SD/mean) to assess ABP variabilities. Measures of TOD included LVMI, left ventricular hypertrophy (LVH), LV systolic shortening, LV diastolic function (e′/a′), and pulse wave velocity. General linear models were used to determine if increased ABP variability measures were significant determinants of TOD in models containing mean ABP percentiles, age, sex, race/ethnicity, BMI z-score, and HR. Results: Mean participant age was 15.6 ± 1.7 years (63% white, 59% male) with mean casual BP 122.6/71.6 mmHg ±12.4/10.5, and mean awake systolic ABP 124.2/72.0 ± 11.3/7.7 mmHg. In linear models, increased awake CV-DBP and HR dipping were significant determinants of LVMI. CV-HR was an independent determinant of diastolic (e′/a′) but not systolic dysfunction. Using logistic regression, the combination of awake and asleep diastolic ABP variability and awake systolic ABP percentile improved the prediction of LVH. Conclusions: Consideration of ABP variability in addition to ABP percentile may aid in identifying adolescents at risk for LVH.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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