The Relationship between the 24-hour Ambulatory Pulse Pressure and Left Ventricular Mass Index in Elderly Patients with Essential Hypertension_West China Medical Journal

Authors：

 LIHong-jian , HANSu-xia

Department of Cardiology, the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, P. R. China;

Corresponding author：

Keywords：

Essential hypertension; Elderly; Ambulatory pulse pressure; Left ventricular mass index

DOI：

10.7507/1002-0179.20140502

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Objective To investigate the relationship of 24-hour ambulatory pulse pressure (24hPP) with left ventricular mass index (LVMI) in elderly essential hypertension patients. Methods The data of 110 elderly patients with essential hypertension from January to December 2012 were collected in the study. All patients received 24-hour ambulatory blood pressure monitoring and echoeardiographic examination 24hPP and LVMI were calculated according to the results of 24-hour ambulatory blood pressure monitoring and echocardiographic measurements. The patients were divided into group A [24hPP<60 mm Hg (1 mm Hg=0.133 kPa), n=70] and group B (24hPP≥60 mm Hg, n=40). Results The 24-hour systolic blood pressure and 24hPP for patients in group B were significantly higher than those in group A (P<0.001). Compared with group A patients, the interventricular septal thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index were significantly higher in group B (P<0.05). Pearson correlation analysis showed that 24hPP had a positive correlation with LVMI in the elderly essential hypertension patients (r=0.33, P<0.001). Multiple stepwise regression analysis showed that 24hPP was the main factor for the increase of LVMI in elderly essential hypertension patients (β=0.90, P<0.001). Conclusion The 24hPP is positively correlated with LVMI in elderly essential hypertension patients. The 24hPP is an important risk factor for left ventricular structural damage in elderly essential hypertensive patients.

Citation： LIHong-jian, HANSu-xia. The Relationship between the 24-hour Ambulatory Pulse Pressure and Left Ventricular Mass Index in Elderly Patients with Essential Hypertension. West China Medical Journal, 2014, 29(9): 1635-1638. doi: 10.7507/1002-0179.20140502 Copy

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10.	刘平,王砚青,赵艳芳,等.老年高血压病患者24h动态脉压与左室结构及功能变化的相关性研究[J].中华老年多器官疾病杂志,2011,10(1):33-35.
11.	Zieman SJ,Melenovsky V,Kass DA.Mechanisms,pathophysiology,and therapy of arterial arterial stiffness[J].Arterioscler Thromb Vasc Biol,2005,25(5):932-943.
12.	吴镜,蔡琳,王伟,等.脉压对高血压病患者左心室肥厚的影响[J].华西医学,2009,24(8):2125-2127.
13.	Kao YT,Huang CC,Leu HB,et al.Ambulatory pulse pressure as a novel predictor for long-term prognosis in essential hypertensive patients[J].J Hum Hypertens,2011,25(7):444-450.
14.	Angeli F,Angeli E,Ambrosio G,et al.Neutrophil count and ambulatory pulse pressure as predictors of cardiovascular adverse events in postmenopausal women with hypertension[J].Am J Hypertens,2011,24(5):591-598.
15.	Gu YM,Thijs L,Li Y,et al.Outcome-driven thresholds for ambulatory pulse pressure in 9938 participants recruited from 11 populations[J].Hypertension,2014,63(2):229-237.
16.	Palmas W,Pickering TG,Teresi J,et al.Ambulatory blood pressure monitoring and all-cause mortality in elderly People with diabetes mellitus[J].Hypertension,2009,53(2):120-127.
17.	Laugesen E,Rossen NB,Poulsen PL,et al.Pulse pressure and systolic night-day ratio interact in prediction of macrovascular disease in patients with type 2 diabetes mellitus[J].J Hum Hypertens,2012,26(3):164-170.
18.	姚华丽,戴秋艳.降压药物对脉压的影响[J].中华高血压杂志,2011,19(4):320-323.

1. Franklin SS,Larson MG,Khan SA,et al.Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study[J].Circulation,2001,103(9):1245-1249.
2. Dolan E,Stanton A,Thijs L,et al.Superiority of ambulatory over clinic blood pressure measurement in predicting mortality:the Dublin outcome study[J].Hypertension,2005,46(1):156-161.
3. Kikuya M,Ohkubo T,Asayama K,et al.Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality:the Ohasama study[J].Hypertension,2005,45(2):240-245.
4. Sega R,Facchetti R,Bombelli M,et al.Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population:follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study[J].Circulation,2005,111(14):1777-1783.
5. Conen D,Bamberg F.Noninvasive 24-h ambulatory blood pressure and cardiovascular disease:a systematic review and meta-analysis[J].J Hypertens,2008,26(7):1290-1299.
6. Page SP,Pantazis A,Elliott PM.Acute myocardial ischemia associated with latent left ventricular outflow tract obstruction in the absence of left ventricular hypertrophy[J].J Am Soc Echocardiogr,2007,20(6):772.e1-772.e4.
7. 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
8. Devereux RB,Alonso DR,Lutas EM,et al.Echocardiographic assessment of left ventricular hypertrophy:comparison to necropsy findings[J].Am J Cardiol,1986,57(6):450-458.
9. Mancia G,Fagard R,Narkiewicz K,et al.2013 ESH/ESC guidelines for the management of arterial hypertension:the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)[J].Eur Heart J,2013,34(28):2159-2219.
10. 刘平,王砚青,赵艳芳,等.老年高血压病患者24h动态脉压与左室结构及功能变化的相关性研究[J].中华老年多器官疾病杂志,2011,10(1):33-35.
11. Zieman SJ,Melenovsky V,Kass DA.Mechanisms,pathophysiology,and therapy of arterial arterial stiffness[J].Arterioscler Thromb Vasc Biol,2005,25(5):932-943.
12. 吴镜,蔡琳,王伟,等.脉压对高血压病患者左心室肥厚的影响[J].华西医学,2009,24(8):2125-2127.
13. Kao YT,Huang CC,Leu HB,et al.Ambulatory pulse pressure as a novel predictor for long-term prognosis in essential hypertensive patients[J].J Hum Hypertens,2011,25(7):444-450.
14. Angeli F,Angeli E,Ambrosio G,et al.Neutrophil count and ambulatory pulse pressure as predictors of cardiovascular adverse events in postmenopausal women with hypertension[J].Am J Hypertens,2011,24(5):591-598.
15. Gu YM,Thijs L,Li Y,et al.Outcome-driven thresholds for ambulatory pulse pressure in 9938 participants recruited from 11 populations[J].Hypertension,2014,63(2):229-237.
16. Palmas W,Pickering TG,Teresi J,et al.Ambulatory blood pressure monitoring and all-cause mortality in elderly People with diabetes mellitus[J].Hypertension,2009,53(2):120-127.
17. Laugesen E,Rossen NB,Poulsen PL,et al.Pulse pressure and systolic night-day ratio interact in prediction of macrovascular disease in patients with type 2 diabetes mellitus[J].J Hum Hypertens,2012,26(3):164-170.
18. 姚华丽,戴秋艳.降压药物对脉压的影响[J].中华高血压杂志,2011,19(4):320-323.

West China Medical Journal

The Relationship between the 24-hour Ambulatory Pulse Pressure and Left Ventricular Mass Index in Elderly Patients with Essential Hypertension

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