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Pulse pressure is the best predictor of future left ventricular mass and change in left ventricular mass: 10 years of follow-up. J Hypertens 2001 Nov;19(11):2047-54

Date

10/26/2001

Pubmed ID

11677371

DOI

10.1097/00004872-200111000-00016

Scopus ID

2-s2.0-0034756561 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

BACKGROUND: Ambulatory blood pressure correlates more closely with left ventricular mass (LVM) than casual blood pressure in cross-sectional studies, but prospective evidence is very limited.

OBJECTIVE: To evaluate the best predictors of LVM and change in LVM during 10 years of follow-up, in a prospective study.

METHODS: At baseline, blood pressure was recorded by casual measurements and 24 h intra-arterial ambulatory monitoring. The study participants were 97 healthy, untreated, 35-45-year-old men (34 normotensive, 29 borderline hypertensive, and 34 mildly hypertensive). At 10-year follow-up, echocardiography was performed in 86 (89%) of the men; echocardiographic data were available both at baseline and at follow-up from 70 (72%) of them. Individuals who were not receiving antihypertensive medication (n = 66) were included in the prediction of LVM index (LVMI), which was analysed as a continuous variable.

RESULTS: The blood pressure variables that were best in predicting the LVMI were: 24 h pulse pressure (r = 0.308, P = 0.012), night-time pulse pressure (r = 0.291, P = 0.018), daytime pulse pressure (r = 0.253, P = 0.041), and casual systolic blood pressure (r = 0.212, P = 0.088). The LVMI was best predicted by a model including 24 h pulse pressure, positive family history of hypertension, body mass index, and age (adjusted coefficients of determination (adj.R2) = 0.197; that for the casual blood pressure model was adj.R2 = 0.140). During the follow-up, LVMI increased by +7.5 g/m2 and +23 g/m2 in individuals receiving and not receiving antihypertensive medication, respectively (P = 0.015). The change in LVMI was best predicted by the change in casual pulse pressure and use of antihypertensive medication (adj.R2 = 0.102).

CONCLUSIONS: Ambulatory blood pressure improved the prediction of future LVMI compared with that obtained from casual measurements. To our knowledge, this is the longest prospective follow-up to show that pulse pressure is the most significant blood pressure parameter in predicting future LVMI and change in LVMI.

Author List

Jokiniitty JM, Majahalme SK, Kähönen MA, Tuomisto MT, Turjanmaa VM

Author

Silja Majahalme MD, PhD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antihypertensive Agents
Blood Pressure
Cardiomegaly
Echocardiography
Follow-Up Studies
Forecasting
Heart Ventricles
Humans
Hypertension
Male
Middle Aged
Prospective Studies
Pulse