Association of either left ventricular hypertrophy or diastolic dysfunction with 24-hour central and peripheral blood pressure

Pedro Blanch, Pedro Armario, Anna Oliveras, Patricia Fernández-Llama, Susana Vázquez, Julia Pareja, Empar Álvarez, Francesca Calero, Cristina Sierra, Alejandro De La Sierra

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    Abstract

    © American Journal of Hypertension, Ltd 2018. All rights reserved. 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.
    Original languageEnglish
    Pages (from-to)1293-1299
    JournalAmerican Journal of Hypertension
    Volume31
    Issue number12
    DOIs
    Publication statusPublished - 1 Jan 2018

    Keywords

    • Ambulatory blood pressure monitoring
    • Blood pressure
    • Central blood pressure
    • Hypertension
    • Left ventricular hypertrophy
    • Target organ damage

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    Blanch, P., Armario, P., Oliveras, A., Fernández-Llama, P., Vázquez, S., Pareja, J., Álvarez, E., Calero, F., Sierra, C., & De La Sierra, A. (2018). Association of either left ventricular hypertrophy or diastolic dysfunction with 24-hour central and peripheral blood pressure. American Journal of Hypertension, 31(12), 1293-1299. https://doi.org/10.1093/ajh/hpy123