Key result
Higher awake and 24-h-weighted short-term systolic blood pressure variabilities were significantly associated with early depressed left ventricular systolic function (P=0.038 and P=0.002 for cESS).
Why the study?
Is short-term blood pressure variability associated with early left ventricular systolic dysfunction in newly diagnosed untreated hypertensive patients?
Observational (n=309)
Is short-term blood pressure variability associated with early left ventricular systolic dysfunction in newly diagnosed untreated hypertensive patients?
In newly diagnosed, untreated hypertensive patients with normal LVEF, higher short-term systolic blood pressure variability is associated with early subclinical left ventricular systolic dysfunction.
Should not yet change hypertension practice; leaves open whether short-term SBP variability predicts LV progression.
BACKGROUND AND AIM: Twenty-four-hour blood pressure (BP) variability, by ambulatory BP monitoring (ABPM), has been related to left ventricular hypertrophy, independent of mean BP values. We tested the hypothesis that short-term BP variability (BPV) is also related to subclinical left ventricular systolic dysfunction. METHODS: We assessed 24-h SBP and DBP variabilities, quantified as standard deviation (SD) of daytime (awake) BP values and as weighted SD of 24-h BP (24-h-weighted BPV), in 309 recently (<6 months) diagnosed, prospectively recruited, and untreated hypertensive patients. Patients were included only if with normal (≥55%) left ventricular ejection fraction (LVEF). Left ventricular systolic function was assessed by echocardiography measuring midwall fractional shortening (MFS), circumferential end-systolic stress (cESS), MFS/cESS, peak systolic wall stress, left ventricular fractional shortening (LVFS), and LVEF. RESULTS: At multivariate analysis, awake and 24-h-weighted SBP variabilities (directly, P = 0.038 and P = 0.002, respectively) as well as relative wall thickness (RWT) (inversely, P = 0.001) were significantly related to cESS. Awake and 24-h SBP average values (inversely, P = 0.011 and P = 0.002, respectively), awake and 24-h-weighted SBP variabilities (inversely, P = 0.017 and P = 0.024, respectively), and RWT (directly, P = 0.001) were all significantly related to MFS/cESS. Finally, awake and 24-h average SBP (directly, P = 0.01 for both), awake and 24-h-weighted SBP variability (directly, P = 0.001 and P = 0.032, respectively), and RWT (inversely, P = 0.001) were all significantly and independently related to peak systolic wall stress. CONCLUSION: In newly diagnosed never-treated hypertensive patients, in the absence of LVEF changes and independent of left ventricular mass index, higher awake, or 24-h-weighted short-term SBP variabilities are associated with early depressed left ventricular systolic function.
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Tatasciore et al. (2013) conducted an observational in newly diagnosed untreated hypertension (n=309). Short-term blood pressure variability was evaluated on Left ventricular systolic function (cESS, MFS/cESS, peak systolic wall stress). Higher awake and 24-h-weighted short-term systolic blood pressure variabilities were significantly associated with early depressed left ventricular systolic function (P=0.038 and P=0.002 for cESS).
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