Relations of pulse pressure and other components of blood pressure to preclinical echocardiographic abnormalities.
OBJECTIVE
To evaluate the extent to which pulse pressure (PP) is associated with echocardiographic abnormalities, and in particular to whether PP is related to LV hypertrophy taking into account other blood pressure (BP) components.


METHODS
Cross-sectional.


METHODS
University hospital, hypertension outpatient unit.


METHODS
A total of 275 adults (mean age 47 years, range 19-69, 3% aged > or = 65) with essential hypertension. Overt coronary artery disease, valvular disease and secondary hypertension were exclusion criteria. Subjects were divided in two groups with PP < or = 50 or PP > 50 mmHg.


METHODS
Left ventricular (LV) mass, hypertrophy, LV systolic dysfunction.


RESULTS
Prevalence of LV hypertrophy was higher in subjects with clinic PP > 50 mmHg. Subjects with PP > 50 mmHg had higher clinic and ambulatory systolic than subjects with PP < or = 50 mmHg while diastolic BP did not differ between groups. PP and systolic BP, either clinic or ambulatory, showed similar correlation to LV hypertrophy in separate logistic multivariate models. Using different methodologies, PP was not related to LV mass index or hypertrophy when the effect of its component systolic BP was taken into account. In separate analyses, PP was not significantly related to ejection fraction or midwall mechanics.


CONCLUSIONS
Middle-aged clinically healthy hypertensives with PP > 50 mmHg had two-fold higher prevalence of LV hypertrophy than those with PP < or = 50 mmHg, which may contribute to the higher cardiovascular risk in subjects with higher PP. However, in our sample, PP was not related to LV hypertrophy independently of systolic BP, suggesting that systolic BP is the explanatory link of the relation between PP and LV hypertrophy.
Celentano
Aldo
A
Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy.
Palmieri
Vittorio
V
Di Palma Esposito
Nunzia
N
Pietropaolo
Ilaria
I
Arezzi
Emma
E
Mureddu
Gian Francesco
GF
de Simone
Giovanni
G
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011674:Pulse; D012720:Severity of Illness Index; D013599:Systole