Pulse pressure responses to psychological tasks improve the prediction of left ventricular mass: 10 years of follow-up.
OBJECTIVE
To examine the role of casual blood pressure measurements and blood pressure responses to psychological tasks in the prediction of future left ventricular mass index (LVMI), and to determine the importance of different components of blood pressure, and the predictive value of an individual's personal characteristics and antihypertensive medication on future LVMI.


METHODS
At baseline, blood pressure was recorded by casual measurements; during tests it was recorded by intra-arterial monitoring. The participants were healthy, untreated 35-45-year old men. Echocardiography data both at baseline and after 10 years of follow-up were available from 65 individuals, of whom 49 (75%) were not taking antihypertensive medication at follow-up. Those not taking antihypertensive medication were included in the prediction of LVMI (g/m2).


RESULTS
Baseline LVMI correlated significantly with future LVMI only among the 49 unmedicated individuals (r = 0.52, P < 0.0001). The predictive value of baseline LVMI on future LVMI among them (adjusted coefficient of determination = 0.26) was not improved by the inclusion of casual blood pressure. In contrast, blood pressure responses to the psychological tasks improved the prediction of future LVMI by 4-13%. Pulse pressure was the blood pressure variable that entered the final prediction models; the correlations with future LVMI were best for pulse pressure response to habituation task (r = 0.43, P < 0.05) and to relaxation (r = 0.37, P < 0.05).


CONCLUSIONS
To our knowledge, this is the longest prospective follow-up to show that blood pressure responses to psychological tasks improve the prediction of LVMI compared with casual blood pressure measurements. The pulse pressure, which reflects the properties of the arterial wall, is the most significant blood pressure variable in predicting future LVMI.
Jokiniitty
Jaana M
JM
Department of Clinical Physiology, Medical School, University of Tampere, Finland. jaana.jokiniitty@uta.fi
Tuomisto
Martti T
MT
Majahalme
Silja K
SK
Kähönen
Mika A P
MA
Turjanmaa
Väinö M H
VM
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011581:Psychological Tests