Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients
Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients
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DOI：
10.1038/hr.2011.54
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发表时间：
2011-07-01
影响因子：
5.4
通讯作者：
Goda, Fuminori
中科院分区：
文献类型：
--
作者：
Masugata, Hisashi;Senda, Shoichi;Goda, Fuminori
尽管最近证实收缩压(SBP)的来访变异性是中风的一个强有力的预测因子，但尚无高血压患者SBP变异性与心脏损害之间的关系的数据。我们比较了在接受治疗的患者中，SBP的来访变异性与左心室(LV)舒张期功能不全之间的关系，以及SBP值与心脏参数之间的关系。40名接受治疗的高血压患者(69+/-9岁)在为期一年的时间里每1个月或2个月在门诊测量一次血压。标准差(S.D.)计算了这一年的SBP和最大SBP与最小SBP之间的差值，以评估就诊之间的变异性。并计算了该年的平均SBP。应用多普勒超声心动图测定二尖瓣环舒张期早期血流速度(E/A)、二尖瓣环血流速度(E‘)及E/E’比值(E/E‘)，评价左室舒张功能。E/A仅与S.D.相关。收缩压(r=-0.327，P=0.040)，而e‘与舒张压呈正相关。收缩压(r=-0.496，P=0.001)和最大-最小收缩压差(r=-0.490，P 0.001)。E/E‘与S.D.相关。收缩压(r=0.384，P=0.014)、最大-最小收缩压差(r=0.410，P=0.009)、平均收缩压(r=0.349，P=0.028)。多元回归分析显示最大-最小收缩压差仅与E/e‘独立相关(β=0.410，P=0.009)。因此，与SBP的平均值相比，SBP的来访变异性与左室舒张功能不全有更好的相关性。SBP的高就诊-就诊变异性与左室舒张功能不全相关，并可能构成高血压患者舒张性心力衰竭的高危因素。高血压研究(2011年)34846-850DOI：10.1038/hr.2011.54；2011年5月12日在线发布
Although visit-to-visit variability in systolic blood pressure (SBP) has recently been demonstrated to be a strong predictor of stroke, there are no data about relationships between SBP variability and cardiac damage in hypertensive patients. We compared relationships between visit-to-visit variability in SBP and left ventricular (LV) diastolic dysfunction with the relationships between the mean SBP value and cardiac parameters in treated patients. Forty treated hypertensive patients (69 +/- 9 years of age) had their blood pressure measured at outpatient clinics every 1 or 2 months over a 1-year period. The standard deviation (s.d.) of SBP and the difference between the maximum and minimum SBPs during this year were calculated to assess visit-to-visit variability. The mean SBP during the year was also calculated. LV diastolic function was assessed by the ratio (E/A) of early (E) and late (A) diastolic transmitral flows, early diastolic mitral annular velocity (e') and the ratio (E/e') of E to e' using Doppler echocardiography. E/A only correlated with the s.d. of SBP (r = -0.327, P = 0.040), whereas e' correlated with s.d. of SBP (r = -0.496, P = 0.001) and maximum-minimum SBP difference (r = -0.490, P 0.001). E/e' correlated with s.d. of SBP (r = 0.384, P = 0.014), maximum-minimum SBP difference (r = 0.410, P = 0.009), and the mean value of SBP (r = 0.349, P = 0.028). Multiple regression analysis demonstrated only the maximum-minimum SBP difference independently associated with E/e' (beta = 0.410, P = 0.009). Thus, the visit-to-visit variability of SBP showed better correlation with LV diastolic dysfunction than mean values of SBP. High visit-to-visit variability of SBP was associated with LV diastolic dysfunction and may constitute a high risk for diastolic heart failure in hypertensive patients. Hypertension Research (2011) 34, 846-850; doi:10.1038/hr.2011.54; published online 12 May 2011