Home blood pressure telemonitoring reveals race-specific patterns of target organ damage.

Authors

Dong-Yan Zhang, De-Wei An, Yu-Ling Yu, Błażej P Kaleta, Gontse Mokwatsi, Dries S Martens, Olugbenga O Abiodun, Tina Anya, Ruan Kruger, Godsent Isiguzo, Hui-Zhong Shi, Zhi-Kai Yang, Yu-Chen Wang, Muhammad N Shehu, Laurenço Chemo, Martin Salazar, Walter Espeche, Jana Brguljan-Hitij, Agnieszka Olszanecka, Aletta E Schutte, Agnieszka Łebek-Szatańska, Wiktoria Wojciechowska, Marek Rajzer, Andrzej Januszewicz, Katarzyna Stolarz-Skrzypek, Tim S Nawrot, Albertino Damasceno, Augustine N Odili, Jan A Staessen, UPRIGHT-HTM investigators

Published in

Journal of hypertension. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

Racial differences in cardiac and renal target organ damage (TOD) may persist at comparable blood pressure levels. This study compared TOD in high-risk, non-African-American Black and White patients in relation to the home blood pressure (HBP).
UPRIGHT-HTM (NCT04299529) is an ongoing international trial comparing risk stratification strategies in asymptomatic patients, aged 55-75  years, with ≥5 risk factors. Patients engage in HBP telemonitoring (OMRON HEM 9210-T). After 34.7 months (median), 287 Black and 154 White patients underwent echocardiography. At baseline, their chronic kidney disease (CKD) grade was assessed by cross-classification of the race-free estimated glomerular filtration rate and albuminuria (2024 KDIGO guideline). HBP was stratified by the 2024 ESC thresholds. Linear and logistic regression models, including a race-by-HBP interaction term, were applied to assess associations with the home systolic HBP.
The number of HBP readings was 252 215. Median systolic/diastolic HBP was 127/77 mmHg with 142 patients (32.2%) having home hypertension. Fewer Black patients received statins or combination therapy for hypertension or diabetes. Among nonhypertensive White compared to Black patients, left atrial dimensions, mitral annular s', and stroke volume had a steeper slope in relation to systolic HBP. All patients had concentric left ventricular remodeling, but only 4 Black and 13 White patients had an ejection fraction < 50%. CKD grade was worse in Black than White patients without association with HBP.
TOD primarily affects the kidney in Black and the heart in White patients. Intensifying pharmacological treatment in sub-Saharan Africa, including antihypertensives, lipid-lowering agents, antidiabetic medications, and aspirin, should create an opportunity for improved overall cardiovascular and metabolic prevention.

PMID:
42474350
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.

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