Document Detail


Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study.
MedLine Citation:
PMID:  20051906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We previously demonstrated stronger relations of central vs. brachial blood pressure, particularly pulse pressure, to carotid artery hypertrophy and extent of atherosclerosis. Data regarding the relative impacts of central and brachial pressures on left ventricular hypertrophy and geometry are limited. METHODS: Echocardiography and radial applanation tonometry were performed in American Indian participants in the 4th Strong Heart Study examination. Left ventricular mass was calculated using an anatomically validated formula and adjusted for height. Brachial blood pressure was measured according to a standardized protocol. Central pressures were derived using a generalized transfer function. RESULTS: Of 2585 participants in the analysis, 60% were women, 21% had diabetes and 33% were hypertensive; the mean age was 40 +/- 17 years. All blood pressure variables were significantly related to left ventricular absolute and relative wall thicknesses and left ventricular mass index (all P < 0.001), with considerable variation in correlation coefficients (r = 0.135-0.432). Central and brachial systolic pressures were uniformly more strongly related to left ventricular wall thicknesses, diastolic diameter and mass index than their respective pulse pressures (all P < 0.005 by z statistics). Left ventricular relative wall thickness and mass index were more strongly related to central than brachial pressures. CONCLUSION: Left ventricular hypertrophy is more strongly related to systolic pressure than to pulse pressure. Furthermore central pressures are more strongly related than brachial pressures to concentric left ventricular geometry. These data suggest that absolute (systolic) pressure is more important in stimulating left ventricular hypertrophy and remodeling, whereas pulsatile stress (pulse pressure) is more important in causing vascular hypertrophy and atherosclerosis.
Authors:
Mary J Roman; Peter M Okin; Jorge R Kizer; Elisa T Lee; Barbara V Howard; Richard B Devereux
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-20     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  384-8     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Weill Cornell Medical College, New York 10021, USA. mroman@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology*
Brachial Artery
Diabetes Complications / pathology,  physiopathology,  ultrasonography
Echocardiography
Female
Humans
Hypertension / complications,  pathology*,  physiopathology*,  ultrasonography
Hypertrophy, Left Ventricular / etiology,  pathology*,  physiopathology*,  ultrasonography
Indians, North American
Longitudinal Studies
Male
Manometry
Middle Aged
Pulse
Radial Artery
United States
Ventricular Remodeling
Young Adult
Grant Support
ID/Acronym/Agency:
HL41642/HL/NHLBI NIH HHS; HL41652/HL/NHLBI NIH HHS; HL41654/HL/NHLBI NIH HHS; HL65521/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Hypertens. 2010 Feb;28(2):237-9   [PMID:  20087105 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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