Relation of Blood Pressure Variability to Left Ventricular Function and Arterial Stiffness in Hypertensive Patients

Overview

Journal Singapore Med J

Specialty General Medicine

Date 2019 Mar 12

PMID 30854570

Citations 6

Authors

Sung-Hee Shin

Ji-Hoon Jang

Yong-Soo Baek

Sung-Woo Kwon

Sang-Don Park

Seong-Ill Woo

Dae-Hyeok Kim

Jun Kwan

Affiliations

Soon will be listed here.

Abstract

Introduction: Variability of blood pressure (BP) has been reported to be related to worse cardiovascular outcomes. We examined the impact of daytime systolic BP variability on left ventricular (LV) function and arterial stiffness in hypertensive patients.

Methods: Ambulatory BP monitoring (ABPM) and echocardiography were performed in 116 hypertensive patients. We assessed BP variability as standard deviations of daytime systolic BP on 24-hour ABPM. Conventional echocardiographic parameters, area strain and three-dimensional diastolic index (3D-DI) using 3D speckle tracking were measured. Arterial stiffness was evaluated by acquiring pulse wave velocity (PWV) and augmentation index.

Results: Patients with higher BP variability showed significantly increased left ventricular mass index (LVMI) and late mitral inflow velocity, as well as decreased E/A (early mitral inflow velocity/late mitral inflow velocity) ratio, area strain and 3D-DI than those with lower BP variability (LVMI: p = 0.02; A velocity: p < 0.001; E/A ratio: p < 0.001; area strain: p = 0.02; 3D-DI: p = 0.04). In addition, increased BP variability was associated with higher PWV and augmentation index (p < 0.001). Even among patients whose BP was well controlled, BP variability was related to LV mass, diastolic dysfunction and arterial stiffness.

Conclusion: Increased BP variability was associated with LV mass and dysfunction, as well as arterial stiffness, suggesting that BP variability may be an important determinant of target organ damage in hypertensive patients.

Citing Articles

The Depiction of Hypertension in Heart Imaging Examinations: An Up-to-Date Review of the Evidence.

Vasileiadis K, Antza C, Kotsis V Vasc Health Risk Manag. 2023; 19:789-796.

PMID: 38045022 PMC: 10693270. DOI: 10.2147/VHRM.S436133.

Ambulatory blood pressure monitoring in children: A retrospective single-center study.

Ahlenius M, Koek W, Yamaguchi I Front Pediatr. 2023; 11:1088857.

PMID: 36776905 PMC: 9911535. DOI: 10.3389/fped.2023.1088857.

The Role of Cumulative Mean Arterial Pressure Levels in First Stroke Events Among Adults with Hypertension: A 10-Year Prospective Cohort Study.

Wang D, Wang J, Liu J, Qin Y, Lou P, Zhang Y Clin Epidemiol. 2022; 14:665-676.

PMID: 35548264 PMC: 9081206. DOI: 10.2147/CLEP.S359284.

Comment on: Relation of blood pressure variability to left ventricular function and arterial stiffness in hypertensive patients.

Caminiti G, Ferdinando I, Massaro R, Volterrani M Singapore Med J. 2022; 62(11):616.

PMID: 35001134 PMC: 8804416. DOI: 10.11622/smedj.2021228.

Hypertension-mediated organ damage regression associates with blood pressure variability improvement three years after successful treatment initiation in essential hypertension.

Triantafyllidi H, Benas D, Schoinas A, Birmpa D, Trivilou P, Varytimiadi E J Clin Hypertens (Greenwich). 2021; 23(6):1150-1158.

PMID: 33554428 PMC: 8678708. DOI: 10.1111/jch.14209.

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