Association of Either Left Ventricular Hypertrophy or Diastolic Dysfunction With 24-Hour Central and Peripheral Blood Pressure. (1st August 2018)

• Record Type: Journal Article
• Authors: Blanch, Pedro; Armario, Pedro; Oliveras, Anna; Fernández-Llama, Patricia; Vázquez, Susana; Pareja, Julia; Álvarez, Empar; Calero, Francesca; Sierra, Cristina; de la Sierra, Alejandro
• Is Part Of: American journal of hypertension. Volume 31:Number 12(2018:Dec.)
• Page Start: 1293
• Page End: 1299
• Publication Date: 2018-08-01
• Subjects: ambulatory blood pressure monitoring -- blood pressure -- central blood pressure -- hypertension -- left ventricular hypertrophy -- target organ damage; Hypertension -- Periodicals; 616.132005
• DOI: 10.1093/ajh/hpy123
• Languages: English
• ISSNs: 0895-7061

Abstract

Abstract: BACKGROUND: Central blood pressure (BP) is considered as a better estimator of hypertension-associated risks than peripheral BP. We aimed to evaluate the association of 24-hour central BP, in comparison with 24-hour peripheral BP, with the presence of left ventricular hypertrophy (LVH), or diastolic dysfunction (DD). METHODS: The cross-sectional study consisted of 208 hypertensive patients, aged 57 ± 12 years, of which 34% were women. Office and 24-hour central and peripheral BP were measured by the oscillometric Mobil-O-Graph device. We performed echocardiography–Doppler measurements to calculate LVH and DD, defined as left atrium volume ≥34 ml/m 2 or septal e′ velocity <8 cm/s or lateral e′ velocity <10 cm/s. RESULTS: Seventy-seven patients (37%) had LVH, and 110 patients (58%) had DD. Systolic and pulse BP estimates (office, 24-hour, daytime, and nighttime) were associated with the presence of LVH or DD, after adjustment for age, gender, and antihypertensive treatment, with higher odds ratios for ambulatory-derived values. The comparison between central and peripheral BP estimates did not reveal a statistically significant superiority of the former neither in multiple regression models with simultaneous adjustments nor in the comparison of areas under receiver-operating curves. Correlation coefficients of BP estimates with left ventricular mass, although numerically higher for central BP, did not significantly differ between central and peripheral BP. CONCLUSIONS: We have not found a significant better association of 24-hour central over peripheral BP, with hypertensive cardiac alterations, although due to the sample size, these results require further confirmation in order to assess the possible role of routine 24-hour central BP measurement.