Relation of blood pressure variability to left ventricular function and arterial stiffness in hypertensive patients

Abstract

O r i g i n a l A r t i c l e 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.

Visit-to-Visit Blood Pressure Variability and Target Organ Damage in Rural Dwellers With Uncomplicated Arterial Hypertension

“…The present study, enrolled predominantly young and middle-age males with uncomplicated AH, demonstrated that HBPV was associated with more pronounced AH-mediated subclinical target organ damage, namely the LV mass index, carotid arteries and kidneys, which was in agreement with other available studies [12,13,[25][26][27]. Moreover, HBPV was also associated with more advanced hypertensive retinopathy, that may reflect potential pathophysiological associations of BP variability with retinal microvascular abnormalities in AH [29,30]. At the same time, the obtained results are worth consideration due to several aspects.…”

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

“… 32 Likewise, increased BPV has been associated with arterial stiffness and LV mass and dysfunction in treated and untreated hypertensive population, suggesting that BPV may be an important determinant of HMOD. 33 , 34 , 35 In a group of elderly hospitalized patients, 24‐h SBPV could reflect the degree of HMOD as it was associated with IMT, LVMI and MAU. 36 In a 7‐year follow‐up study of a small hypertensive group ( n = 73), Frattola et al reported that the BP level achieved by treatment, the degree of HMOD at baseline evaluation and the long‐term BPV were the most important determinants of future end‐organ damage related to hypertension throughout the years of follow‐up.…”

Hipertansiyon Hastalarında Sistolik Kan Basıncı Değişkenliği ve Kardiyovasküler Riskin Vekil Belirteçleri Arasındaki İlişki

“…The patient cohort in this study was based on the Maastricht Study, which consists of type 2 diabetes mellitus patients, and PWV was measured to document aortic stiffness. Shin et al also reported an association between daytime SBPV and arterial stiffness, which was also documented with PWV (19). PWV measurement has several limitations, such as estimation of the length of the arterial system, estimation of a unidirectional pathway for pulse pressure to travel and close relation with instant BP and heart rate at the time of measurement (20).…”