title: Midlife blood pressure predicts future diastolic dysfunction independently of blood pressure.
abstract: High blood pressure (BP) is associated with diastolic dysfunction, but the consequence of elevated BP over the adult life course on diastolic function is unknown. We hypothesised that high BP in earlier adulthood would be associated with impaired diastolic function independent of current BP.
  
  
  
  Participants in the Medical Research Council National Survey of Health and Development birth cohort (n=1653) underwent investigations including echocardiography at age 60-64 years. The relationships between adult BP, antihypertensive treatment (HTT) and echocardiographic measures of diastolic function were assessed using adjusted regression models.
  
  
  
  Increased systolic BP (SBP) at ages 36, 43 and 53 years was predictive of increased E/e' and increased left atrial volume. These effects were only partially explained by SBP at 60-64 years and increased left ventricular mass. HTT was also associated with poorer diastolic function after adjustment for SBP at 60-64 years. Faster rates of increase in SBP in midlife were also associated with increased poorer diastolic function.
  
  
  
  High SBP in midlife is associated with poorer diastolic function at age 60-64 years. Early identification of individuals with high BP or rapid rises in BP may be important for prevention of impaired cardiac function in later life.
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
authors.forename: Arjun Kumar
authors.initials: AK
authors.lastname: Ghosh
authors.affiliation: Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Alun David
authors.initials: AD
authors.lastname: Hughes
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Darrel
authors.initials: D
authors.lastname: Francis
authors.affiliation: Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Nishi
authors.initials: N
authors.lastname: Chaturvedi
authors.affiliation: Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
authors.forename: Denis
authors.initials: D
authors.lastname: Pellerin
authors.affiliation: Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.affiliation: Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Jamil
authors.initials: J
authors.lastname: Mayet
authors.affiliation: Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D016277:Ventricular Function, Left