Serial blood pressure measurements, left ventricular remodelling and cardiovascular outcomes
© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation..
BACKGROUND: Hypertension is a risk factor for the development of cardiovascular disease. Whether serial blood pressure (BP) measurements are more closely associated with subclinical left ventricular (LV) remodelling and better predict risk of cardiovascular events over individual BP measurements are not known.
METHODS: We assessed systolic BP, diastolic BP and pulse pressure at several time points during adulthood in 1333 women and 1211 men participating in the Akershus Cardiac Examination 1950 Study. We defined serial BP measurements as the sum of averaged BPs from adjacent consecutive visits indexed to total exposure time between measurements. We assessed the associations between serial and individual BP measurements and (1) LV structure, function and volumes and (2) incident myocardial infarction, ischemic stroke, heart failure and cardiovascular death.
RESULTS: All indices of higher serial BP measurements were associated with increased indexed LV mass, and the associations were stronger than those of individual BP measurements. Serial diastolic BP pressure was strongly and inversely associated with LV systolic function, while higher serial systolic BP was primarily associated with higher LV volumes. Both serial systolic (incidence rate ratio [IRR] 1.10, 95% CI 1.03 to 1.17) and diastolic BPs (IRR 1.14, 95% CI 1.02 to 1.27) were associated with increased incidence of clinical events.
CONCLUSION: In healthy community dwellers without established cardiovascular disease, different serial BP indices associate strongly with LV remodelling and cardiovascular outcomes. Whether the use of serial BP indices for guiding treatment is superior to individual measurements should be explored in additional prospective studies.
Errataetall: |
CommentIn: Eur J Clin Invest. 2023 Jan;53(1):e13902. - PMID 36349443 |
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Medienart: |
E-Artikel |
Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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Enthalten in: |
European journal of clinical investigation - 53(2023), 1 vom: 01. Jan., Seite e13876 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Lyngbakken, Magnus Nakrem [VerfasserIn] |
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Links: |
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Themen: |
Echocardiography |
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Anmerkungen: |
Date Completed 14.12.2022 Date Revised 08.04.2023 published: Print-Electronic CommentIn: Eur J Clin Invest. 2023 Jan;53(1):e13902. - PMID 36349443 Citation Status MEDLINE |
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doi: |
10.1111/eci.13876 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM346375282 |
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500 | |a Citation Status MEDLINE | ||
520 | |a © 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation. | ||
520 | |a BACKGROUND: Hypertension is a risk factor for the development of cardiovascular disease. Whether serial blood pressure (BP) measurements are more closely associated with subclinical left ventricular (LV) remodelling and better predict risk of cardiovascular events over individual BP measurements are not known | ||
520 | |a METHODS: We assessed systolic BP, diastolic BP and pulse pressure at several time points during adulthood in 1333 women and 1211 men participating in the Akershus Cardiac Examination 1950 Study. We defined serial BP measurements as the sum of averaged BPs from adjacent consecutive visits indexed to total exposure time between measurements. We assessed the associations between serial and individual BP measurements and (1) LV structure, function and volumes and (2) incident myocardial infarction, ischemic stroke, heart failure and cardiovascular death | ||
520 | |a RESULTS: All indices of higher serial BP measurements were associated with increased indexed LV mass, and the associations were stronger than those of individual BP measurements. Serial diastolic BP pressure was strongly and inversely associated with LV systolic function, while higher serial systolic BP was primarily associated with higher LV volumes. Both serial systolic (incidence rate ratio [IRR] 1.10, 95% CI 1.03 to 1.17) and diastolic BPs (IRR 1.14, 95% CI 1.02 to 1.27) were associated with increased incidence of clinical events | ||
520 | |a CONCLUSION: In healthy community dwellers without established cardiovascular disease, different serial BP indices associate strongly with LV remodelling and cardiovascular outcomes. Whether the use of serial BP indices for guiding treatment is superior to individual measurements should be explored in additional prospective studies | ||
650 | 4 | |a Journal Article | |
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650 | 4 | |a epidemiology | |
650 | 4 | |a heart failure | |
650 | 4 | |a hypertension | |
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700 | 1 | |a Berge, Trygve |e verfasserin |4 aut | |
700 | 1 | |a Pervez, Mohammad Osman |e verfasserin |4 aut | |
700 | 1 | |a Aagaard, Erika Nerdrum |e verfasserin |4 aut | |
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700 | 1 | |a Omland, Torbjørn |e verfasserin |4 aut | |
700 | 1 | |a Tveit, Arnljot |e verfasserin |4 aut | |
700 | 1 | |a Steine, Kjetil |e verfasserin |4 aut | |
700 | 1 | |a Røsjø, Helge |e verfasserin |4 aut | |
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