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Increasing ambulatory pulse pressure predicts the development of left ventricular hypertrophy during long-term follow-up

Journal of Human Hypertension volume 32, pages 180–189 (2018)Cite this article

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Abstract

Ambulatory blood pressure (ABP) has been shown to have an association with left ventricular hypertrophy (LVH). We evaluated the association between ABP characteristics and the development of LVH during long-term follow-up (20 years) in 420 middle-aged subjects from OPERA cohort. ABP measurements (ABPM) were recorded and echocardiographic examinations were performed at baseline and revisit. Anthropometrics were measured and laboratory analyses performed at visit. The questionnaire presented to all participants elicited detailed information about their habits. Left ventricular mass index (LVMI) was calculated according to Troys method. Baseline LVMI was a significant independent predictor of LVMI change (p < 0.001). None of the baseline continuous ABPM predicted the change in LVMI. A greater increase in daytime and night-time systolic blood pressure (BP) (p from 0.006 to 0.048) and 24 h, daytime and night-time pulse pressure (PP) (p from 0.005 to 0.034) predicted a greater increase in LVMI. Especially the increase in night-time SBP (p = 0.006) and PP (p = 0.005) predicted a greater increase in LVMI. We also considered circadian BP profiles among subjects, whose ABPM at baseline and echocardiographic measurements both at baseline and follow-up were available. Diastolic non-dippers were observed to show a greater increase in LVMI compared to diastolic dippers (10.6 ± 33.0 g/m2 vs. 7.0 ± 28.8 g/m2, p = 0.032), when baseline LVMI and in-office DBP were taken account. These findings suggest that an increasing ambulatory PP increases and a diastolic non-dipping status may increase the risk for the development of LVH during later life course.

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Acknowledgements

We acknowledge the excellent technical assistance of Mrs Saija Kortetjärvi and Mrs Heidi Häikiö. This study was supported by the Finnish Foundation for Cardiovascular Research.

Funding

The study is supported by a grant from the Finnish Foundation for Cardiovascular Research.

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Authors and Affiliations

  1. Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland

    Tero J. W. Pääkkö, Juha S. Perkiömäki, Y. Antero Kesäniemi, Jarmo A. Lumme, Heikki V. Huikuri & Olavi H. Ukkola

  2. Lappi Central Hospital, Rovaniemi, University of Oulu, Oulu, Finland

    Antti S. Ylitalo

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  1. Tero J. W. Pääkkö
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Correspondence to Tero J. W. Pääkkö.

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Pääkkö, T.J.W., Perkiömäki, J.S., Kesäniemi, Y.A. et al. Increasing ambulatory pulse pressure predicts the development of left ventricular hypertrophy during long-term follow-up. J Hum Hypertens 32, 180–189 (2018). https://doi.org/10.1038/s41371-018-0034-5

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