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Peer-reviewedCC BY-NCJournal of clinical hypertension (Greenwich, Conn.)

Above-Threshold Ambulatory Systolic Pressure and Left Ventricular Mass in Chronic Kidney Disease: Does AUC Add Beyond Mean Pressure?

  1. 1Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.
  2. 2Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Above-threshold ambulatory systolic blood pressure (SBP) area under the curve (AUC) captures both the magnitude and duration of SBP above daytime and nighttime reference values. We examined whether this measure provided information about left ventricular mass index (LVMI) beyond daytime and nighttime mean SBP. In this cross-sectional study, 212 Chinese adults with non-dialysis chronic kidney disease (CKD) underwent ambulatory blood pressure monitoring and echocardiography. Daytime AUC above 135 mmHg and nighttime AUC above 120 mmHg were entered jointly. Together, daytime and nighttime AUC were significantly associated with LVMI (P < 0.001; adjusted R² = 0.345). From the 25th to the 75th percentile, adjusted LVMI was 3.46 g/m²·⁷ higher for daytime AUC and 5.56 g/m²·⁷ higher for nighttime AUC. AUC attributable to daytime and nighttime mean SBP accounted for 89.7% of the cohort-average above-threshold burden. The remaining AUC not captured by those period means was not significantly associated with LVMI after adjustment for daytime and nighttime mean SBP (0.69 g/m²·⁷ per interquartile range; 95% confidence interval, -2.00 to 3.37). Above-threshold AUC was associated with greater LVMI but added limited information beyond daytime and nighttime mean SBP in this cohort.

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BibTeX
@article{zhang2026abovethreshold,
  title = {{Above-Threshold Ambulatory Systolic Pressure and Left Ventricular Mass in Chronic Kidney Disease: Does AUC Add Beyond Mean Pressure?}},
  author = {Zhen Zhang and Xinyue Dong and Xiaoqiang Ding and Wuhua Jiang and Yi Fang},
  journal = {Journal of clinical hypertension (Greenwich, Conn.)},
  year = {2026},
  month = oct,
  doi = {10.1111/jch.70378},
  url = {https://europepmc.org/article/MED/42951829},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Above-Threshold Ambulatory Systolic Pressure and Left Ventricular Mass in Chronic Kidney Disease: Does AUC Add Beyond Mean Pressure?
AU  - Zhen Zhang
AU  - Xinyue Dong
AU  - Xiaoqiang Ding
AU  - Wuhua Jiang
AU  - Yi Fang
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical hypertension (Greenwich, Conn.)
DO  - 10.1111/jch.70378
UR  - https://europepmc.org/article/MED/42951829
AB  - Above-threshold ambulatory systolic blood pressure (SBP) area under the curve (AUC) captures both the magnitude and duration of SBP above daytime and nighttime reference values. We examined whether this measure provided information about left ventricular mass index (LVMI) beyond daytime and nighttime mean SBP. In this cross-sectional study, 212 Chinese adults with non-dialysis chronic kidney disease (CKD) underwent ambulatory blood pressure monitoring and echocardiography. Daytime AUC above 135 mmHg and nighttime AUC above 120 mmHg were entered jointly. Together, daytime and nighttime AUC were significantly associated with LVMI (P < 0.001; adjusted R² = 0.345). From the 25th to the 75th percentile, adjusted LVMI was 3.46 g/m²·⁷ higher for daytime AUC and 5.56 g/m²·⁷ higher for nighttime AUC. AUC attributable to daytime and nighttime mean SBP accounted for 89.7% of the cohort-average above-threshold burden. The remaining AUC not captured by those period means was not significantly associated with LVMI after adjustment for daytime and nighttime mean SBP (0.69 g/m²·⁷ per interquartile range; 95% confidence interval, -2.00 to 3.37). Above-threshold AUC was associated with greater LVMI but added limited information beyond daytime and nighttime mean SBP in this cohort.
SN  - 1524-6175
SN  - 1751-7176
ER  -