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Effect of intensive versus standard blood pressure lowering on diastolic function in patients with uncontrolled

Scott D Solomon1, Anil Verma, Akshay Desai

  • 1Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA. Ssolomon@rics.bwh.harvard.edu

Hypertension (Dallas, Tex. : 1979)
|December 10, 2009
PubMed

Insights

Intensive blood pressure control in hypertensive patients with diastolic dysfunction improved myocardial relaxation. Lower systolic blood pressure targets were associated with greater diastolic function improvements, suggesting a link between blood pressure reduction and cardiac health.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Diastolic Heart Function

Background:

  • Diastolic dysfunction is a precursor to heart failure in patients with hypertension.
  • Optimizing blood pressure control is crucial for managing hypertensive heart disease.

Purpose of the Study:

  • To compare the effects of intensive versus standard blood pressure targets on diastolic function in hypertensive patients.
  • To investigate the relationship between blood pressure reduction and improvements in diastolic relaxation.

Main Methods:

  • A randomized trial involving 228 hypertensive patients with preserved ejection fraction and diastolic dysfunction.
  • Two treatment strategies: intensive (systolic blood pressure <130 mm Hg) and standard (systolic blood pressure <140 mm Hg).
  • Medications included valsartan and amlodipine, with echocardiography assessing diastolic function at baseline and 24 weeks.

Main Results:

  • Both intensive and standard strategies significantly reduced blood pressure.
  • Myocardial relaxation velocity improved significantly in both groups.
  • No significant difference in diastolic function improvement between the intensive and standard groups.
  • Greater systolic blood pressure reduction correlated with higher diastolic relaxation velocities.

Conclusions:

  • Intensive blood pressure lowering did not show superior improvement in diastolic function compared to standard care in this cohort.
  • The extent of systolic blood pressure reduction is a key factor influencing diastolic relaxation improvement.
  • Further research may explore optimal blood pressure targets for preserving diastolic function in hypertensive patients.

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