SHORT-TERM BLOOD PRESSURE VARIBILITY AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: To determine the association of short-term blood pressure variability (BPV) with left ventricular diastolic dysfunction (LVDDF) in patients with arterial hypertension. Design and method: A retrospective analysis of data from outpatient department of the Institute of cardiovascular diseases of Vojvodina during 2020 was conducted. NYHA I patients, with treated arterial hypertension and preserved left ventricular ejection fraction, without diagnosed cardiovascular disease and diabetes mellitus were included. Indices of short-term BPV standard deviation (SD) and coefficient of variation (CV), and average real variability (ARV) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) during 24 h, daytime and nighttime were calculated from 24 h ambulatory blood pressure monitoring. LVDDF was determined according to the 2016 recommendations of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Results: The study included 108 patients, mean age 60.74 ± 13.20 years, 55 (50.9%) were male. 71 (65.7%) patients had preserved diastolic function, 27 (25%) had stage I DDF, 7 (6.5%) stage II DDF, and stage III DDF 2 (2.8%). There were statistically significant higher daytime diastolic BP AVR with higher LVDDF stages (p = 0.014). Daytime diastolic BP AVR was the independent predictor of LVDDF presence (OR 1.32 95% CI (1.074–1.623); p = 0.008), independent predictor of e’septal velocity < 0.07m/s or e’lateral velocity< 0.1m/s (OR 1.29 95% CI (1.04–1.60); p = 0.020), and the only predictor of TR velocity > 2.8m/s (OR 1.47 95% CI (1.10–1.96); p = 0.009). No examined indices were ssociated with LA Volume index> 34 ml/m2 and E/e’> 14. Conclusions: In the examined group of patients with arterial hypertension, daytime diastolic BP AVR was the independent predictor of left ventricular DDF presence, which may suggest that daytime diastolic BP variability could be important for development of heart failure with preserved left ventricular ejection fraction.