Isolated Nocturnal Hypertension and Target Organ Damage: A SHIP-AHOY Ancillary Study.

Authors

Taylor Hill-Horowitz, Meredith Akerman, Michael Ferguson, Joseph Flynn, Coral Hanevold, Marc Lande, Kevin Meyers, Mark Mitsnefes, Joshua Samuels, Christine Sethna, Elaine Urbina, Abby Basalely

Published in

Research square. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

Background Isolated nocturnal hypertension (INH) and its relationship to target organ damage (TOD) is poorly studied in pediatrics. This study aims to examine the epidemiology of INH in the Study of Hypertension in Pediatrics, Adult Hypertension Onset in Youth (SHIP-AHOY) cohort and its association with TOD. INH is hypothesized to be associated with an increased risk of TOD. Methods Data were obtained from SHIP-AHOY participants. Primary exposure was INH, defined using static thresholds (wake < 130/80, sleep ≥ 110/65) and using the 95th percentile for ambulatory blood pressure (BP). Primary outcome was left ventricular hypertrophy (LVH), defined as left ventricular mass index > 38.6 g/m ^2.7 . Logistic regression evaluated the association of INH with LVH, adjusted for age, sex, cardiovascular risk factor score, and BP tolerability. Results Using static thresholds, INH was present in 19.7% of adolescents, 61% due to systolic BP only. Age and height were greater in INH than normotension (16.1v15.4 years, P = 0.008) (168.9v166.4 cm, P = 0.036). Other demographics and anthropometric variables did not significantly differ. INH had lower estimated glomerular filtration rate (96.3v100.3 ml/min/1.73m ² , P = 0.027). Among INH, 27% (N = 18/68) had LVH. Wake and clinic BPs were higher, but not hypertensive, in INH. INH was associated with a 2.7-fold increase in adjusted odds of LVH compared to normotension (95%CI [1.20,5.93], P = 0.016). Use of 95th percentiles resulted in a lower prevalence of INH (10%) and LVH (19%). Conclusions INH is prevalent and associated with 2.7-fold adjusted odds of LVH compared to normotension in adolescents. Longitudinal studies are needed to characterize long-term implications of INH.

PMID:
42427833
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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