Association Of Blood Pressure Variability With Body Mass Index And Left Ventricular Diastolic Function In Hypertensive Patients

ObjectivesThe aim of this study was to investigate the association of blood pressurevariability (BPV) with body mass index (BMI) and left ventricular diastolic functionin patients with essential hypertension.MethodsRetrospective clinical data in429hospitalized subjects with essentialhypertension were collected in Fujian Provincial Hospital from November2011toJanuary2014. All subjects were divided into normal-weight group, overweight groupand obese group according to BMI. BPV and left ventricular diastolic function werecompared among groups. BPV, circadian rhythms of blood pressure, morning bloodpressure surge were obtained by analysis of24h ambulatory blood pressuremonitoring. Left ventricular diastolic function was obtained by echocardiography.Multiple analysis were performed to examine the relationship between BPV，BMI andleft ventricular diastolic function.Results1. Twenty-four-hour standard deviation of diastolic blood pressure (24hDBPSD)was significantly different in normal-weight, overweight and obese patients afteradjusting for age and sex (P<0.05). Multiple linear regression analysis showed that24hDBPSD was positively correlated with BMI (P<0.05). Multiple logistic regressionanalysis showed that the odds ratio (OR) of being overweight in the fourth quartilewas1.868[95%confidence interval (CI):1.067~3.273, P<0.05] compared with that inthe first quartile of24hDBPSD. The percentage of non-dipper blood pressure typewas86.9%in all subjects. Systolic BPV was not correlated with BMI. Circadianrhythms of blood pressure and morning blood pressure surge were not significantly different in three groups (P>0.05).2. Left ventricular end-diastolic volume (LVEDV) was higher in overweightgroup and obese group than that in normal-weight group (P<0.05). Multiple linearregression analysis showed that LVEDV was positively correlated with BMI (P<0.05).Multiple logistic regression analysis showed that the OR of obesity in the fourthquartile was3.081(95%CI:1.103~8.600, P<0.05) compared with that in the firstquartile of LVEDV.3. Patients with abnormal isovolumic relaxation time (IVRT) had higherstandard deviation of day systolic blood pressure (dSBPSD) than those with normalIVRT (P<0.05). Multiple linear regression analysis showed that IVRT was positivelycorrelated with dSBPSD (P<0.05). Patients with abnormal ratio of peak early diastolicmitral flow velocity to peak early diastolic mitral annular velocity (E/Ea ratio) hadhigher coefficient variation of24h diastolic blood pressure (24hDBPCV) than thosewith normal E/Ea ratio (P<0.05). Multiple linear regression analysis showed that E/Earatio was positively correlated with24hDBPCV (P<0.05). Multiple logistic regressionanalysis showed that the OR of abnormal E/Ea ratio in the third and the secondquartile was10.093(95%CI:1.545~65.974, P<0.05) and7.568(95%CI:1.059~54.086, P<0.05) respectively, compared with that in the first quartile of24hDBPCV.ConclusionsBMI was positively correlated with24hDBPSD and LVEDV，showing that BMImay be one of the risk factors for BPV. dSBPSD was positively correlated with IVRTand24hDBPCV was positively correlated with E/Ea ratio, which suggesting BPVmay be an independent risk factor for left ventricular diastolic dysfunction. Weightcontrol may be helpful in improvement of BPV and left ventricular diastolic functionfor hypertensive patients.