Central arterial stiffness and systemic vascular resistance influence on left ventricular geometry and diastolic function in essential hypertension

Purpose: Vascular resistance remains a key determinant of arterial hypertension and target organ damage alters morbidity of the disease. Our aim is to investigate physiology and clinical relevance of the left ventricular and systemic vascular interaction in essential hypertension patients. Methods: 112 participants enrolled the study. Systolic (SBP) and diastolic blood pressure (DBP) as well as pulse pressure (PP) assessed the blood pressure load. Based on 2D echocardiography, left ventricular mass index (LVMI) and Doppler E/ E′ ratio determinate ventricular geometry and diastolic performance respectively. Pulse wave velocity (PWV) was measured as determinant of central arterial stiffness and systemic vascular resistance (SVR) was calculated by the ratio of the mitral regurgitation velocity jet to the time velocity integral on the left ventricular outflow tract. We used standard Pearson correlations and bivariate regression analyses on matched pairs of surrogate variables. Results: Participants demographics included mean age of 53 years old (27–74), BMI of 32 kg/m2 (23–44), SBP of 142 mm Hg (137–172), and DBP of 84 mm Hg (60–110). Bivariate-r values for the chosen models are shown in Table. SVR was strongly correlated with both LVMI, E/E′ and PWV (all P<0.001). All associations remained significant in logistic regression models after adjustment for age and BP. Conclusions: LV geometry and diastolic performance are unfavorably influenced by both central arterial stiffness and systemic vascular resistance in primary hypertension. Our data reveal clinical information and interesting pathophysiology background in addition to standard BP components (SAP, DAP) in essential hypertension patients.