Key result
Pulse pressure > 50 mmHg was associated with a two-fold higher prevalence of LV hypertrophy compared to ≤ 50 mmHg, but this relationship was not independent of systolic blood pressure.
Why the study?
Is pulse pressure > 50 mmHg associated with left ventricular hypertrophy and other echocardiographic abnormalities independently of systolic blood pressure in adults with essential hypertension?
Cross-Sectional (n=275)
No
Is pulse pressure > 50 mmHg associated with left ventricular hypertrophy and other echocardiographic abnormalities independently of systolic blood pressure in adults with essential hypertension?
In middle-aged adults with essential hypertension, the association between higher pulse pressure and left ventricular hypertrophy is driven by systolic blood pressure rather than being an independent effect of pulse pressure.
Association of elevated pulse pressure with LVH is not independent of systolic BP; leaves open whether pulse pressure adds prognostic value beyond SBP.
OBJECTIVE: To evaluate the extent to which pulse pressure (PP) is associated with echocardiographic abnormalities, and in particular to whether PP is related to LV hypertrophy taking into account other blood pressure (BP) components. DESIGN: Cross-sectional. SETTING: University hospital, hypertension outpatient unit. PARTICIPANTS: A total of 275 adults (mean age 47 years, range 19-69, 3% aged > or = 65) with essential hypertension. Overt coronary artery disease, valvular disease and secondary hypertension were exclusion criteria. Subjects were divided in two groups with PP < or = 50 or PP > 50 mmHg. OUTCOME MEASURES: Left ventricular (LV) mass, hypertrophy, LV systolic dysfunction. RESULTS: Prevalence of LV hypertrophy was higher in subjects with clinic PP > 50 mmHg. Subjects with PP > 50 mmHg had higher clinic and ambulatory systolic than subjects with PP < or = 50 mmHg while diastolic BP did not differ between groups. PP and systolic BP, either clinic or ambulatory, showed similar correlation to LV hypertrophy in separate logistic multivariate models. Using different methodologies, PP was not related to LV mass index or hypertrophy when the effect of its component systolic BP was taken into account. In separate analyses, PP was not significantly related to ejection fraction or midwall mechanics. CONCLUSION: Middle-aged clinically healthy hypertensives with PP > 50 mmHg had two-fold higher prevalence of LV hypertrophy than those with PP < or = 50 mmHg, which may contribute to the higher cardiovascular risk in subjects with higher PP. However, in our sample, PP was not related to LV hypertrophy independently of systolic BP, suggesting that systolic BP is the explanatory link of the relation between PP and LV hypertrophy.
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Celentano et al. (2002) conducted a cross-sectional in essential hypertension (n=275). Pulse pressure > 50 mmHg vs. Pulse pressure ≤ 50 mmHg was evaluated on Left ventricular (LV) mass, hypertrophy, LV systolic dysfunction. Pulse pressure > 50 mmHg was associated with a two-fold higher prevalence of LV hypertrophy compared to ≤ 50 mmHg, but this relationship was not independent of systolic blood pressure.
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