Correlation between rhythm of blood pressure,blood pressure levels and left ventricular diastolic dysfunction
Objective To investigate the relationship between circadian rhythm of blood pressure,different blood pressure levels and left ventricular diastolic dysfunction in patients with essential hypertension.Methods A total of 678 patients underwent ambulatory blood pressure monitoring and echocardiography were included.Group studies were performed according to the circadian rhythm of blood pressure.Left ventricular diastolic function was assessed using the left atrial volume index(LAVI),early diastolic mitral inflow velocity/early diastolic mitral annular tissue velocity(E/e')、early diastolic mitral annular tissue velocity(e').Analysis of variance(ANOVA)and multiple linear regression were used to analyze the relationship between blood pressure parameters and left ventricular diastolic function.Results LAVI was significantly higher in the anti-dipping patterns than in the dipping patterns(P<0.05).The result of the multivariable liner regression analyses show that 24 h-SBP,D-mSBP and N-mSBP were independently associated with LAVI(P<0.001).24 h-mSBP,D-mSBP,N-mSBP,office systolic blood pressure,24-SBPV,24-DBPV,D-SBPV and D-DBPV were independently associated with E/e'(P<0.05).24h-mSBP,24h-mDBP,N-mDBP and,office diastolic blood pressure were independently associated with e'(P<0.05).Conclusion Anti-dipping patterns and systolic blood pressure were associated with left atrial enlargement.Both mSBP and office systolic blood pressure are correlated with left ventricular diastolic function,and the correlation between mSBP and left ventricular diastolic function was stronger than that of office blood pressure.ABPM can aid in the early identification of hypertensive patients at high risk for left atrial enlargement and left ventricular diastolic dysfunction.
Ambulatory blood pressure monitoringEssential hypertensionCircadian rhythm of blood pressureLeft ventricular diastolic function
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