Ambulatory Pulse Pressure Predicts the Development of Left Ventricular Diastolic Dysfunction in Over 20 Years of Follow-up.

BACKGROUND: Ambulatory blood pressure (ABP) has been shown to have an association with left ventricular diastolic dysfunction (LVDD) in cross-sectional assessments. We evaluated the association between ABP measurement (ABPM) and the development of LVDD during over 20 years of follow up in 414 middle-aged subjects from OPERA cohort.

METHODS: ABPM, clinical, and anthropometric measurements were performed in baseline. Echocardiographic measurements were performed at baseline and during follow-up and E/E' ≥15 was considered indicating significant LVDD.

RESULTS: Several baseline clinical characteristics (age, female gender, short stature, body mass index, prevalence of diabetes, in-office systolic BP (SBP), in-office pulse pressure (PP), N-terminal pro-atrial natriuretic peptide, and the use of antihypertensive therapy) were associated with the development of LVDD. Baseline 24-hour mean, daytime mean or nighttime mean SBP or diastolic BP were not associated with the development of LVDD, neither were different circadian BP profiles. Instead 24-hour mean, daytime mean and nighttime mean PP showed significant association with the development of LVDD (P from <0.001 to 0.001) even after adjustment with significant baseline clinical characteristics (P from 0.001 to 0.016).

CONCLUSION: These findings suggest that ambulatory PP has an independent predictive value in the development of LVDD during over 20 years of follow-up.