title: Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients.
abstract: 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' (β=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.
authors.affiliation: Department of Integrated Medicine, Kagawa University, Kagawa, Japan. masugata@med.kagawa-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Koji
authors.initials: K
authors.lastname: Murao
authors.forename: Michio
authors.initials: M
authors.lastname: Inukai
authors.forename: Naohisa
authors.initials: N
authors.lastname: Hosomi
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Iwado
authors.forename: Takahisa
authors.initials: T
authors.lastname: Noma
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents