title: Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study.
abstract: We tested the prognostic impact of a marker of arterial stiffness, pulse pressure/stroke volume index (PP/SVi), in patients with hypertension and left ventricular (LV) hypertrophy. We used data from 866 patients randomized to losartan or atenolol-based antihypertensive treatment, over a median of 4.8 years, in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. The association of PP/SVi with outcomes was tested in Cox regression analyses and reported as hazard ratio (HR) and 95% confidence intervals (CI). In multivariate regression, reduction of PP/SVi was independently associated with male gender, reduction in systolic blood pressure (BP) and relative wall thickness and with an increase in left ventricular ejection fraction (all p < .05). After adjusting for confounders, higher baseline PP/SVi predicted a 38% higher hazard of combined major fatal and non-fatal cardiovascular events (95% CI 1.04-1.84), and higher hazard of cardiovascular mortality (HR 2.35 (95% CI 1.59-3.48) and stroke (HR 1.45 (95% CI 1.06-1.99) (all p < .05). Higher PP/SVi also predicts higher rate of hospitalization for HF (HR 2.15 (95% CI 1.48-3.12) and a 52% higher hazard of all-cause mortality (95% CI 1.10-2.09) (both p < .05). In hypertensive patients with electrocardiographic LV hypertrophy, higher PP/SVi was associated with increased cardiovascular morbidity and mortality.
authors.affiliation: a Department of Clinical Science , University of Bergen , Bergen , Norway.|b Hypertension Research Center, Federico II University Hospital , Napoli , Italy.|c Department of Translational Medical Sciences , Federico II University Hospital , Naples , Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Mancusi
authors.affiliation: a Department of Clinical Science , University of Bergen , Bergen , Norway.
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.affiliation: b Hypertension Research Center, Federico II University Hospital , Napoli , Italy.|c Department of Translational Medical Sciences , Federico II University Hospital , Naples , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.affiliation: a Department of Clinical Science , University of Bergen , Bergen , Norway.
authors.forename: Helga
authors.initials: H
authors.lastname: Midtbø
authors.affiliation: a Department of Clinical Science , University of Bergen , Bergen , Norway.
authors.forename: Mai Tone
authors.initials: MT
authors.lastname: Lønnebakken
authors.affiliation: d Department of Medicine, Skeleftaa Hospital , University of Umeaa , Skelleftaa , Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.affiliation: e Department of Cardiology , Gentofte Hospital , Copenhagen , Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.affiliation: f Department of Medicine , Sahlgrenska University Hospital/Östra , Göteborg , Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Dahlöf
authors.affiliation: g Division of Cardiology , Weill Medical College of Cornell University , New York , NY , USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D020521:Stroke / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D013318:Stroke Volume / Q000187:drug effects*; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents; D001262:Atenolol; D019808:Losartan
keywords: Arterial stiffness; cardiovascular events; hypertension; prognosis