Left ventricular diastolic function evaluated by the E/e' ratio is impaired in patients with masked uncontrolled hypertension. (December 2014)

• Record Type: Journal Article
• Authors: Komori, Takahiro; Eguchi, Kazuo; Kabutoya, Tomoyuki; Ishikawa, Joji; Hoshide, Satoshi; Kario, Kazuomi
• Is Part Of: Clinical and experimental hypertension. Volume 36:Number 8(2014)
• Page Start: 538
• Page End: 544
• Publication Date: 2014-12
• Subjects: Hypertension -- Chemotherapy -- Periodicals; Hypotensive agents -- Periodicals; 616.132
• DOI: 10.3109/10641963.2014.881839
• Languages: English
• ISSNs: 1064-1963

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>: Masked uncontrolled hypertension (MUH), defined as controlled office blood pressure (BP) but uncontrolled out-of-office BP in treated hypertensives, is a risk factor for cardiovascular disease. We tested the hypothesis that MUH is associated with a greater degree of diastolic dysfunction than controlled hypertension (CH) or uncontrolled hypertension (UH).</p> <p> <italic>Methods and results</italic>: We studied 299 treated patients who had at least one cardiovascular risk factor (age, 63 ± 10 years; male sex, 43%), consisting of 94 (31.4%) patients with UH, 46 (15.4%) with MUH, 56 (18.7%) with treated white-coat hypertension (WCH), and 103 (34.4%) with CH. We performed office and home BP monitoring, electrocardiography, echocardiography and blood tests. Diastolic dysfunction was defined as an E-wave to e'-wave (E/e') ratio ≥8 measured by Doppler echocardiography. The value of E/e' was higher in the MUH (8.3 ± 2.7) and UH (8.3 ± 2.7) groups than in the CH group (7.3 ± 2.3; <italic>p</italic> = 0.08, <italic>p</italic> = 0.02, respectively). In multivariable analysis, MUH was associated with a significantly higher likelihood of diastolic dysfunction than CH (odds ratio 2.90 versus CH, <italic>p</italic> < 0.01) after adjusting for significant covariates.</p> <p> <italic>Conclusions</italic>: MUH and UH were associated with a greater degree of diastolic dysfunction than CH. Even in treated patients, out-of-office BP is important to stratify the risk of cardiovascular disease.</p> </abstract>