Differential relationships of systolic and diastolic blood pressure with components of left ventricular diastolic dysfunction

Abstract

Both SBP and DBP are important determinants of separate components of left ventricular diastolic dysfunction and these effects are noted even within normotensive BP ranges. DBP may be as important as SBP in the transition to diastolic dysfunction.

Relative impact of blood pressure as compared to an excess adiposity on left ventricular diastolic dysfunction in a community sample with a high prevalence of obesity

“…Logistic regression analysis was performed to determine the relative independent effects of indices of adiposity versus SBP or DBP on measures of diastolic function considered as categorical traits. As we have recently demonstrated that SBP is more closely related to E/e 0 and DBP to E/A [17], SBP was employed in models with E/e 0 and DBP in models with E/A. The following additional parameters were included in the regression models: age, sex, regular alcohol or tobacco use, the presence or absence of diabetes mellitus or inappropriate blood glucose control (considered as a single covariate), the use of antihypertensive agents, and pulse rate.…”

“…Clinical, demographic, anthropometric, and blood pressure measurements A standardized questionnaire was administered to obtain demographic and clinical data [17][18][19]. Height, weight, waist circumference, and hip circumference were measured using the standard approaches and participants were identified as being overweight if their BMI was at least 25 kg/m 2 , obese if their BMI was at least 30 kg/m 2 , and morbidly obese if their BMI was at least 35 kg/m 2 .…”

“…Participants gave informed, written consent. The study design has previously been described [17][18][19]. Nuclear families of black African descent with siblings older than 16 years were randomly recruited from the South West Township of Johannesburg, South Africa.…”

“…However, the impact of BP on diastolic dysfunction in these studies [14][15][16] is likely to have been underestimated because BP was considered as a categorical trait (presence or absence of hypertension) and BP effects on diastolic dysfunction are continuous over a wide BP range [17]. Further, in these studies [14][15][16], the differential impact of SBP and DBP on E/e 0 ' versus E/A [17] was not considered and this is also likely to have resulted in an underestimation of BP effects. In the present study, we therefore aimed to compare the relative impact of indices of an excess adiposity versus SBP and DBP considered as continuous traits on E/e 0 and E/A, respectively, in a community sample with a high prevalence of obesity.…”

Reflected rather than forward wave pressures account for brachial pressure-independent relations between aortic pressure and end-organ changes in an African community

“…Left ventricular hypertrophy (LVH) was identified as LVMI above 51 g/m 2.7 [28]. Left ventricular diastolic function was assessed from a pulsed wave Doppler examination of the mitral inflow at rest [29]. Transmitral flow velocity in early (E) and late (atrial) diastole was assessed and data expressed as E/A.…”