Association of left ventricular diastolic dysfunction with 24-h aortic ambulatory blood pressure: the SAFAR study.
Aortic blood pressure (BP) and 24-h ambulatory BP are both better associated with target organ damage than office brachial BP. However, it remains unclear whether a combination of these two techniques would be the optimal methodology to evaluate patients' BP in terms of left ventricular diastolic dysfunction (LVDD) prevention. In 230 participants, office brachial and aortic BPs were measured by a validated BP monitor and a tonometry-based device, respectively. 24-h ambulatory brachial and aortic BPs were measured by a validated ambulatory BP monitor (Mobil-O-Graph, Germany). Systematic assessment of patients' LVDD was performed. After adjustment for age, gender, hypertension and antihypertensive treatment, septum and lateral E/Ea were significantly associated with office aortic systolic BP (SBP) and pulse pressure (PP) and 24-h brachial and aortic SBP and PP (P ⩽ 0.04), but not with office brachial BP (P ⩾ 0.09). Similarly, 1 standard deviation in SBP was significantly associated with 97.8 ± 20.9, 86.4 ± 22.9, 74.1 ± 23.3 and 51.3 ± 22.6 in septum E/Ea and 68.6 ± 2 0.1, 54.2 ± 21.9, 37.9 ± 22.4 and 23.1 ± 21.4 in lateral E/Ea, for office and 24-h aortic and brachial SBP, respectively. In qualitative analysis, except for office brachial BP, office aortic and 24-h brachial and aortic BPs were all significantly associated with LVDD (P ⩽ 0.03), with the highest odds ratio in 24-h aortic SBP. Furthermore, aortic BP, no matter in the office or 24-h ambulatory setting, showed the largest area under receiver operating characteristic curves (P ⩽ 0.02). In conclusion, 24-h aortic BP is superior to other BPs in the association with LVDD.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Y
Y
Zhang
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
G
G
Kollias
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
A A
AA
Argyris
Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
T G
TG
Papaioannou
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
C
C
Tountas
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
G D
GD
Konstantonis
Hypertension Center, 3rd University Department of Medicine, Sotiria Hospital, Athens, Greece.
A
A
Achimastos
Paris Descartes University; AP-HP; Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France.
J
J
Blacher
Paris Descartes University; AP-HP; Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France.
M E
ME
Safar
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
P P
PP
Sfikakis
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
A D
AD
Protogerou
D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002138:Calibration; D003971:Diastole / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*