Short term blood pressure variability and diastolic function in middle-aged normotensive individuals

Abstract

Objective: Blood pressure variability (BPV), a non-conventional blood pressure parameter, has been shown to contribute hypertensive target organ damage but its association with diastolic dysfunction is unknown. The present study investigates the association of BPV and left ventricular diastolic dysfunction (LVDD) in middle-aged normotensive individuals.
 Materials and Methods: 264 normotensive patients aged between 45 and 65 were enrolled. 24-hour ambulatory blood pressure monitoring were performed and BPV was defined as the standard deviation of systolic blood pressure measurements. Patients were divided into 3 groups according to BPV tertiles. Echocardiographic and tissue doppler diastolic function parameters were compared among the groups.
 Results: Mean age of the patients were 50.41 and similar among groups. Mitral inflow E/A (Tertile 1 vs 2 vs 3: 1.10[0.33] vs 1.05 [0.22] vs 1.02 [0.30], p=0.02) and average tissue doppler mitral annular E’ velocity (12 [2] vs 10.5 [1.85] vs 10 [1.55], p=0.02) were highest in the tertile 1 and lowest in the tertile 3. Average E/E’ (Tertile 1 vs 2 vs 3: 7.2 [2.2] vs 8.1 [3.2] vs 9.3 [2.9], p<0.001) was lowest in the tertile 1 and highest in the tertile 3. In addition, there was a positive correlation between BPV and Average E/E’ (Rs =0.401, p<0.001). In contrary, E/A (Rs =- 0.286, p<0.001) and average E’ (Rs =- 0.451, p<0.001) were negatively correlated with BPV.
 Conclusion: BPV is positively correlated with average E/E’ and negatively correlated with E/A and average E’. Further studies are required to elucidate the relationship of BPV and LVDD.