The Relationship Between Visit-to-visit Variability In Systolic Blood Pressure And Left Ventricular Diastolic Dysfunction In Elderly Hypertensive Patients

OBJECTIVES:To analyze the relation of visit-to-visit variability in systolic blood pressure (SBP) with left ventricular diastolic dysfunction.METHODS:Forty elderly hypertensive patients were followed up each month for blood pressure from July2011to July2012in the department of Geriatric Cardiology Outpatient, First Affiliated Hospital of Zhengzhou University. At the end of the1-year observation period, the patients were examinated by color Doppler ultrasound for ventricular septal thickness (VS), left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), LV posterior wall thickness (PW), early diastolic mitral flow speed (E), early diastolic mitral speed (e), carotid intima-media thickness (IMT), the detection of patients with serum brain natriuretic peptide (BNP) levels were also collected,then calculated left ventricular mass index (LVMI), E/e, s.d of SBP was an indicator of BPV, E/e mean diastolic function.RESULTS: E/e, IMT and The standard deviation (s.d.) of SBP were positively correlated (r＝0.384, p＝0.014; r＝0.390, P＝0.013), LVMI did not show statistically significant correlations with the s.d of SBP (r＝0.286, p>0.05). BNP and LVMI showed a significantly positive correlation (r＝0.496, p＝0.001), BNP and E/e were negative related (r＝-0.490, P＝0.001). Multiple linear regression analysis showed that the s.d of SBP, BNP and E/e was significantly associated (β＝-0.380, r2＝-0.132, p＝0.035;β＝0.410,r2＝0.168, p＝0.009).ConclusionThe visit-to-visit variability of SBP showed better correlation with LV diastolic dysfunction than mean values of SBP. High visit-to-visit variability of SBP was associated with LV diastolic dysfunction, which is an independent risk factor of diastolic heart failure.