title: Factors associated with diastolic dysfunction in patients with resistant hypertension: resist-POL study.
abstract: BACKGROUND
  Diastolic dysfunction has been shown to be an independent factor of cardiovascular diseases in patients with hypertension. Very often, obstructive sleep apnea (OSA) and metabolic syndrome (MS) coexist with resistant hypertension (RHTN) and may lead to diastolic dysfunction. Thus, the purpose of this study was to investigate whether OSA and MS are associated with diastolic dysfunction in patients with RHTN independently from other factors, including age, left ventricular mass index (LVMI), and blood pressure (BP).
  
  
  METHODS
  Data from 155 patients (n = 92 men and 63 women) were analyzed. All patients underwent thorough examination, including biochemical evaluations, ambulatory blood pressure monitoring, polysomnography with assessment of apnea/hypopnea index (AHI), and echocardiography. LVMI and diastolic function parameters were obtained.
  
  
  RESULTS
  Patients were divided into 2 groups based on the presence or absence of diastolic dysfunction: group 1 (E' < 10cm/second; n=87) and group 2 (E' > 10cm/second; n = 68). AHI, LVMI, and 24-hour systolic BP/diastolic BP values were higher in group 1. E' correlated with AHI (r = -0.25; P < 0.001), LVMI (r = -0.36; P < 0.0001), 24-h systolic BP/24-h diastolic BP (r = -0.28, P < 0.001; r = -0.30, P < 0.001, respectively), glucose level (r = -0.26; P < 0.01), and abdominal obesity (r = -0.28; P < 0.0001). In multivariable models decreased E' was independently related to the presence of MS or abdominal obesity when separate components of MS were included in the model. Age and 24-hour systolic BP were independently associated with decreased E'. However, the relationship of decreased E' with 24-hour systolic BP was nonsignificant if LVMI was included in the multivariable model.
  
  
  CONCLUSIONS
  MS and abdominal obesity were independently associated with diastolic dysfunction in patients with RHTN. OSA was not confirmed to be an independent factor of diastolic dysfunction.
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland; p.dobrowolski@ikard.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Dobrowolski
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland;
authors.forename: Anna
authors.initials: A
authors.lastname: Klisiewicz
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland;
authors.forename: Aleksander
authors.initials: A
authors.lastname: Prejbisz
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland;
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Florczak
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland;
authors.forename: Justyna
authors.initials: J
authors.lastname: Rybicka
authors.affiliation: IV Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Bieleń
authors.affiliation: IV Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Śliwiński
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland;
authors.forename: Maria
authors.initials: M
authors.lastname: Gosk
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland;
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
authors.affiliation: Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland;
authors.forename: Piotr
authors.initials: P
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left; D055815:Young Adult
keywords: blood pressure; diastolic function; echocardiography; hypertension; metabolic syndrome; obstructive sleep apnea; resistant hypertension.