Serial blood pressure measurements, left ventricular remodelling and cardiovascular outcomes. (24th September 2022)

• Record Type: Journal Article
• Authors: Lyngbakken, Magnus Nakrem; Kvisvik, Brede; Berge, Trygve; Pervez, Mohammad Osman; Aagaard, Erika Nerdrum; Ariansen, Inger; Omland, Torbjørn; Tveit, Arnljot; Steine, Kjetil; Røsjø, Helge
• Is Part Of: European journal of clinical investigation. Volume 53:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-09-24
• Subjects: echocardiography -- epidemiology -- heart failure -- hypertension -- longitudinal population‐based cohorts; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.13876
• Languages: English
• ISSNs: 0014-2972

Abstract

Abstract: Background: Hypertension is a risk factor for the development of cardiovascular disease. Whether serial blood pressure (BP) measurements are more closely associated with subclinical left ventricular (LV) remodelling and better predict risk of cardiovascular events over individual BP measurements are not known. Methods: We assessed systolic BP, diastolic BP and pulse pressure at several time points during adulthood in 1333 women and 1211 men participating in the Akershus Cardiac Examination 1950 Study. We defined serial BP measurements as the sum of averaged BPs from adjacent consecutive visits indexed to total exposure time between measurements. We assessed the associations between serial and individual BP measurements and (1) LV structure, function and volumes and (2) incident myocardial infarction, ischemic stroke, heart failure and cardiovascular death. Results: All indices of higher serial BP measurements were associated with increased indexed LV mass, and the associations were stronger than those of individual BP measurements. Serial diastolic BP pressure was strongly and inversely associated with LV systolic function, while higher serial systolic BP was primarily associated with higher LV volumes. Both serial systolic (incidence rate ratio [IRR] 1.10, 95% CI 1.03 to 1.17) and diastolic BPs (IRR 1.14, 95% CI 1.02 to 1.27) were associated with increased incidence of clinical events. Conclusion: In healthy community dwellers without established cardiovascular disease, different serial BP indices associate strongly with LV remodelling and cardiovascular outcomes. Whether the use of serial BP indices for guiding treatment is superior to individual measurements should be explored in additional prospective studies. Abstract : We assessed systolic blood pressure (BP), diastolic BP and pulse pressure at several time points during adulthood in 2544 subjects participating in the Akershus Cardiac Examination 1950 Study. Serial blood pressure measurements are strongly associated with indexed LV mass, LV systolic function, and LV volumes, as well as risk of incident myocardial infarction, ischemic stroke, heart failure, and cardiovascular death. The associations were stronger than those of single time‐point BP measurements.