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 shortterm 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-hweighted SBP variabilities (directly, P¼0.038 and P¼0.002, respectively) as well as relative wall thickness (RWT) (inversely, P¼0.001) were significantly related to cESS. Awake and 24-h SBP average values (inversely, P¼0.011 and P¼0.002, respectively), awake and 24-hweighted SBP variabilities (inversely, P¼0.017 and P¼0.024, respectively), and RWT (directly, P¼0.001) were all significantly related to MFS/cESS. Finally, awake and 24- h average SBP (directly, P¼0.01 for both), awake and 24- h-weighted SBP variability (directly, P¼0.001 and P¼0.032, respectively), and RWT (inversely, P¼0.001) 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.

Tatasciore, A., Zimarino, M., Tommasi, R., Renda, G., Schillaci, G., Parati, G., et al. (2013). Increased short term blood pressure variability is associated with early left ventricular systolic dysfunction in newly diagnosed untreated hypertensive patients. JOURNAL OF HYPERTENSION, 31, 1653-1661 [10.1097/HJH.0b013e328361e4a6].

Increased short term blood pressure variability is associated with early left ventricular systolic dysfunction in newly diagnosed untreated hypertensive patients.

PARATI, GIANFRANCO;
2013

Abstract

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 shortterm 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-hweighted SBP variabilities (directly, P¼0.038 and P¼0.002, respectively) as well as relative wall thickness (RWT) (inversely, P¼0.001) were significantly related to cESS. Awake and 24-h SBP average values (inversely, P¼0.011 and P¼0.002, respectively), awake and 24-hweighted SBP variabilities (inversely, P¼0.017 and P¼0.024, respectively), and RWT (directly, P¼0.001) were all significantly related to MFS/cESS. Finally, awake and 24- h average SBP (directly, P¼0.01 for both), awake and 24- h-weighted SBP variability (directly, P¼0.001 and P¼0.032, respectively), and RWT (inversely, P¼0.001) 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.
Articolo in rivista - Articolo scientifico
blood pressure variability, hypertension, left ventricular systolic function, midwall fractional shortening
English
2013
31
1653
1661
reserved
Tatasciore, A., Zimarino, M., Tommasi, R., Renda, G., Schillaci, G., Parati, G., et al. (2013). Increased short term blood pressure variability is associated with early left ventricular systolic dysfunction in newly diagnosed untreated hypertensive patients. JOURNAL OF HYPERTENSION, 31, 1653-1661 [10.1097/HJH.0b013e328361e4a6].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/45450
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