{"doi":"10.3389/fcvm.2022.1013876","title":"Relations of postural change in blood pressure with hypertension-mediated organ damage in middle-aged adults of the Framingham heart study: A cross-sectional study","abstract":"Background Dysregulation of compensatory mechanisms to regulate blood pressure (BP) upon postural change is a phenotype of BP variability and an emerging risk factor for cardiovascular outcomes. Materials and methods We assessed postural change in BP (starting 2 min after standing from a supine position), carotid-femoral pulse wave velocity (cfPWV), and markers of hypertension-mediated organ damage (HMOD) in the heart, kidney, and brain in Framingham Third Generation, Omni-2, and New Offspring Spouse Cohort participants. We related vascular measures (postural change in BP measures and cfPWV) with HMOD in 3,495 participants (mean age 47 years, 53% women) using multivariable logistic and linear regression models. Results In multivariable-adjusted models, we did not observe significant associations of vascular measures with presence of left ventricular hypertrophy, albuminuria, covert brain infarcts, or white matter hyperintensities (Bonferroni-adjusted P -values > 0.05/20 > 0.0025). In multivariable models, greater cfPWV (est. β = 0.11 ± 0.03; P < 0.001), but not postural change in BP measures (Bonferroni-adjusted P -values > 0.05/20 > 0.0025), was associated with higher white matter free water using brain magnetic resonance imaging. In multivariable models, greater postural change in pulse pressure was associated with higher urinary albumin-creatinine ratio (est. β = 0.07 ± 0.02; P < 0.001). No other postural change in BP measure was associated with urinary albumin-creatinine ratio (Bonferroni-adjusted P -values > 0.05/20 > 0.0025). In sex-specific analyses, higher cfPWV was associated with higher urinary albumin-creatinine ratio in men (est. β: 0.11 ± 0.04; P = 0.002) but not in women (est. β: 0.03 ± 0.03; P = 0.44). We also observed marginal to strong effect modification by above vs. at/below median postural change in BP for the association of cfPWV with urinary albumin−creatinine ratio (Bonferroni-adjusted interaction P < 0.001–0.01). Vascular measures were not related to left ventricular mass index or fractional anisotropy (Bonferroni-adjusted P -values > 0.05/20 > 0.0025). Conclusion Baroreflex dysfunction is associated with greater subclinical kidney damage. Additionally, relations of higher aortic stiffness with greater kidney damage may be modified by associated baroreflex dysregulation.","journal":"Frontiers in Cardiovascular Medicine","year":2022,"id":293362,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8878,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":743700,"name":"Jian Rong","orcid":"0000-0002-6911-1548","position":1,"is_corresponding":false},{"id":277081,"name":"Pauline Maillard","orcid":"0000-0003-3516-6345","position":2,"is_corresponding":false},{"id":245376,"name":"Alexa Beiser","orcid":"0000-0001-8551-7778","position":3,"is_corresponding":false},{"id":455411,"name":"Naomi Hamburg","orcid":"0000-0001-5504-5589","position":4,"is_corresponding":false},{"id":230820,"name":"Martin G. Larson","orcid":"0000-0002-9631-1254","position":5,"is_corresponding":false},{"id":277082,"name":"Charles DeCarli","orcid":"0000-0003-1914-2693","position":6,"is_corresponding":false},{"id":24661,"name":"Ramachandran S. Vasan","orcid":"0000-0001-7357-5970","position":7,"is_corresponding":false},{"id":17639,"name":"Sudha Seshadri","orcid":"0000-0001-6135-2622","position":8,"is_corresponding":false},{"id":337721,"name":"Gary F. Mitchell","orcid":"0000-0001-5643-3145","position":9,"is_corresponding":false},{"id":739701,"name":"Leroy L. Cooper","orcid":"0000-0001-9764-0837","position":0,"is_corresponding":true}],"reference_count":55,"raw_metadata":null,"created_at":"2026-07-19T00:30:53.818562Z","pmid":"36386360","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}