Change in pulse pressure/stroke index in response to sustained blood pressure reduction and its impact on left ventricular mass and geometry changes: the life study

Am J Hypertens. 2008 Jun;21(6):701-7. doi: 10.1038/ajh.2008.162. Epub 2008 Apr 10.

Abstract

Background: In cross-sectional data in hypertensive subjects, brachial pulse pressure (PP)/Doppler stroke index (SVi), (PP/SVi) correlates weakly but significantly with left ventricular (LV) mass and relative wall thickness (RWT).

Methods: In the Losartan Intervention For End-point reduction in hypertension (LIFE) study, we evaluated the impact of antihypertensive treatment on change of PP/SVi as raw indicator of systemic arterial stiffness, and further explored the impact of the change in PP/SVi on the change in LV mass and RWT.

Results: Compared to baseline, mean PP/SVi reduction was -13% at year 1, -15% at year 2, and -16% at year 3 follow-up, and was sustained through year 4 and year 5 follow-ups; change in PP/SVi was related to increased SVi and decreased PP during the annual follow-ups, but not to LV mass change. Restricting analyses to the first two follow-ups to ensure highest statistical power, age >65 and diabetes were associated with higher PP/SVi at baseline and throughout follow-ups; black participants and women had baseline PP/SVi mean values comparable with those of their counterparts, showed blunted PP/SVi reduction after 1 year, but differences became smaller and not statistically significant at year 2 follow-up. Losartan- or atenolol-based treatments were associated with comparable reduction of PP/SVi. At year 2 follow-up, reduced PP/SVi was associated with greater reductions in mean blood pressure (BP) and heart rate and greater increase in SVi, but not with lower LV mass; RWT was lower with lower PP/SVi at year 2 follow-up.

Conclusions: Reduction in PP/SVi by long-term antihypertensive treatment did not have significant impact on change in LV mass index, but correlated with LV remodeling toward eccentric geometry.

Trial registration: ClinicalTrials.gov NCT00338260.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Arteries / physiopathology
  • Atenolol / therapeutic use
  • Blood Pressure / drug effects*
  • Brachial Artery / physiopathology
  • Cardiac Volume
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Losartan / therapeutic use
  • Male
  • Middle Aged
  • Pulse*
  • Ventricular Function*

Substances

  • Antihypertensive Agents
  • Atenolol
  • Losartan

Associated data

  • ClinicalTrials.gov/NCT00338260