title: Relationship of Office and Ambulatory Blood Pressure With Left Ventricular Global Longitudinal Strain.
abstract: Left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LV ejection fraction (LVEF) is normal, and is an independent predictor of cardiovascular events. Ambulatory blood pressure (BP) is a better predictor of cardiovascular events, including heart failure, than office BP. We investigated the association of office and ambulatory BP measurements with subclinical LV systolic dysfunction in a community-based cohort with normal LVEF.
  
  
  
  Two-dimensional speckle-tracking echocardiography and 24-hour ambulatory BP monitoring were performed in 577 participants (mean age 70±9 years; 60% women) with LVEF ≥50% from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. Univariable and multivariable linear regression analyses were used to assess the associations of BP measures with GLS.
  
  
  
  Higher ambulatory and office BP values were consistently associated with impaired GLS. After adjustment for pertinent covariates (age, sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, LV mass index, and antihypertensive medication), office diastolic BP and ambulatory systolic and diastolic BPs (24-hour, daytime and nighttime) were independently associated with GLS (P = 0.003 for office DBP, P ≤ 0.001 for all ambulatory BPs). When ambulatory and office BP values were included in the same model, all ambulatory BP measures remained significantly associated with GLS (all P < 0.01), whereas office BP values were not.
  
  
  
  Ambulatory BP values are significantly associated with impaired GLS and the association is stronger than for office BP. Ambulatory BP monitoring might have a role in the risk stratification of hypertensive patients for early LV dysfunction.
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.
authors.forename: Fusako
authors.initials: F
authors.lastname: Sera
authors.affiliation: Department of Biostatistics, Columbia University, New York, New York, USA.
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.
authors.forename: Cesare
authors.initials: C
authors.lastname: Russo
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.|Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.affiliation: Department of Neurology, University of Miami, Miami, Florida, USA.|Department of Public Health Sciences, University of Miami, Miami, Florida, USA.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: Department of Neurology, Columbia University, New York, New York, USA.|Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Mitchell S V
authors.initials: MSV
authors.lastname: Elkind
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.affiliation: Department of Neurology, University of Miami, Miami, Florida, USA.|Department of Public Health Sciences, University of Miami, Miami, Florida, USA.|Department of Human Genetics, University of Miami, Miami, Florida, USA.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: Department of Medicine, Columbia University, New York, New York, USA.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis; D016277:Ventricular Function, Left