Ambulatory Blood Pressure Variability in Prediction of Target Organ Injury: The Ship Ahoy Study

Authors

• Coral D Hanevold
• Jang Dong Seo
• Stephen R Daniels
• Bonita E Falkner
• Michael A Ferguson
• Joseph T Flynn
• Julie R Ingelfinger
• Philip R Khoury
• Marc B Lande
• Kevin E Meyers
• Mark Mitsnefes
• Joshua Samuels
• Elaine M Urbina

Language

English

Publication Date

12-1-2026

Journal

Pediatric Nephrology

DOI

10.1007/s00467-025-06803-4

PMID

40387918

PMCID

PMC12416511

PubMedCentral® Posted Date

9-9-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

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.

Keywords

Humans, Male, Adolescent, Blood Pressure Monitoring, Ambulatory, Female, Hypertension, Hypertrophy, Left Ventricular, Blood Pressure, Pulse Wave Analysis, Heart Rate, Risk Factors, Vascular Stiffness, blood pressure variability, heart rate variability, left ventricular hypertrophy, blood pressure, diastolic dysfunction

Published Open-Access

yes

Recommended Citation

Hanevold, Coral D; Seo, Jang Dong; Daniels, Stephen R; et al., "Ambulatory Blood Pressure Variability in Prediction of Target Organ Injury: The Ship Ahoy Study" (2026). Faculty, Staff and Student Publications. 4273.
https://digitalcommons.library.tmc.edu/uthmed_docs/4273