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Static and pulsatile blood pressure correlates of left ventricular structure and function in black and white young
J M Flack1, J M Gardin, C Yunis
1Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
Insights
Systolic blood pressure is the strongest correlate of left ventricular mass in young adults, but associations vary by ethnicity and sex. Pulse pressure may indicate favorable heart function, unlike in older adults.
Area of Science:
- Cardiology
- Hypertension Research
- Vascular Biology
Background:
- Blood pressure is linked to left ventricular mass.
- The relative impact of static versus pulsatile blood pressure on cardiac structure and function in young adults remains unclear.
Purpose of the Study:
- To assess the unbiased association of systolic, diastolic, and pulse pressure with left ventricular mass and function.
- To compare the relative strengths of these blood pressure components in young adults.
Main Methods:
- Cross-sectional analysis of 3918 young adults.
- Data collected from four CARDIA clinical centers between 1990-1991.
- Examined associations between blood pressure components and left ventricular mass/function parameters.
Main Results:
- Left ventricular mass correlated positively with systolic, diastolic, and pulse pressure (except diastolic in white men).
- Systolic blood pressure was the strongest blood pressure correlate of left ventricular mass, followed by pulse pressure, then diastolic pressure.
- Pulse pressure correlated with stroke volume, while static measures did not, except in black men.
Conclusions:
- Systolic blood pressure is the primary blood pressure correlate of left ventricular mass in young adults, with variations across ethnicity and sex.
- Pulse pressure's association with favorable left ventricular function suggests a different implication compared to older hypertensive populations.
Objective:
To determine the unbiased relative strength of the association of static (systolic and diastolic) and pulsatile (pulse pressure) blood pressure components with left ventricular mass and function.
Background:
Blood pressure is correlated with left ventricular mass; however, the unbiased relative strength of static and pulsatile blood pressure components with left ventricular mass and function is unknown in young adults.
Methods:
Cross-sectional analyses of 3918 young adult participants at 4 community-based CARDIA clinical centers during 1990 and 1991.
Results:
Left ventricular mass positively correlated (P <.01) with systolic, diastolic, and pulse pressure in all ethnicity-sex groups except for diastolic blood pressure in white men (P =.19). The association rank ordered as systolic blood pressure > pulse pressure > diastolic blood pressure except in white men, in whom pulse pressure and systolic blood pressure reversed positions in this hierarchy. Systolic blood pressure was the third and fourth strongest independent correlate of left ventricular mass in men and women, respectively. Body mass index, followed by height, was the strongest correlate of left ventricular mass in both sexes. Left ventricular wall thickness/chamber radius ratio positively correlated with diastolic and systolic blood pressure (women only) (P <.05) but not with pulse pressure. In all groups, stroke volume positively correlated (P <.05) with pulse pressure but was unrelated to static blood pressure measures, except for systolic blood pressure in black men. Left ventricular mass and the ventricular wall thickness/chamber radius ratio were greater in blacks compared with whites.
Conclusions:
Although systolic blood pressure was consistently the strongest unbiased blood pressure correlate of left ventricular mass, this relation varied by ethnicity and sex. Pulse pressure correlated with favorable left ventricular function and geometry, suggesting an opposite meaning to the ominous prognosis of wide pulse pressure in hypertensive, older adults.