Leg blood pressure measured in orthostatic posture is associated with left ventricular mass in normotensive subjects.
BACKGROUND
Changing from a supine to an orthostatic posture is associated with substantial increments in leg blood pressure (BP) levels, which could ultimately influence the hemodynamic burden imposed on the heart. This study investigated the relationship between brachial and leg BP measurements and the left cardiac chamber's structure and assessed the role of body posture changes in this regard.


METHODS
One hundred and thirty normotensive, nondiabetic, nonsmoking, normolipemic subjects were evaluated by a clinical history, anthropometry, the analysis of metabolic parameters, echocardiography, and the measurement of BP in the arm and the calf in both supine and orthostatic positions.


RESULTS
Significant correlation coefficients between the leg BP measurements and the cardiac structure were detected, especially between the orthostatic pulse pressure (PP) and the left ventricular (LV) wall thickness (r = 0.38; P < 0.001), the orthostatic PP and the LV mass (r = 0.37; P < 0.001), and the orthostatic systolic BP (SBP) and the left atrial size (r = 0.35; P < 0.001). Stepwise and standard regression analysis adjusted for brachial BP and anthropometric and metabolic variables confirmed that the leg orthostatic PP was independently related to the LV wall thickness and mass. Moreover, the leg orthostatic SBP was associated with the left atrial dimension even after adding the LV mass to the statistical models. Finally, triglyceride levels and body surface area showed significant relationship with leg orthostatic PP and SBP, whereas brachial orthostatic PP and SBP were only associated with age and anthropometric variables.


CONCLUSIONS
Orthostatic leg BP is independently associated with the cardiac structure in normotensive subjects.
Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil.
Tiago
T
Gemignani
José R
JR
Matos-Souza
Kleber G
KG
Franchini
Wilson
W
Nadruz
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply / Q000502:physiology; D008297:Male; D011187:Posture