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Effect of different ranges of systolic blood pressure on left ventricular structure and diastolic function in a Chinese population: a cross-sectional population-based Shunyi study.

BMJ OPEN(2019)

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摘要
Objectives To evaluate the effect of different ranges of systolic blood pressure (SBP) on left ventricular (LV) geometry and diastolic function in Chinese population. Design Cross-sectional study. Setting Peking Union Medical College Hospital in Beijing, China. Participants All inhabitants aged 35 years or older, living in five villages of Shunyi were invited. Exclusion criteria included individuals who declined participation, presence of moderate to severe valvular heart disease, persistent atrial fibrillation and suboptimal echocardiograms. Interventions The baseline data of 1051 participants were analysed. The relationship between SBP and LV geometric and diastolic function assessed by echocardiography was analysed after adjusting for conventional cardiac risk factors. Results The adjusted value of SBP was independently associated with LV hypertrophy (LVH) and LV diastolic dysfunction (LVDDF) (all p < 0.01). Setting individuals with SBP < 120mm Hg as the reference group (group 1), those with SBP between 120mm Hg and 140mm Hg (group 2) had higher risk odds of LVH and those with SBP >= 140mm Hg (group 3) had higher risk odds of LVH and LVDDF (all p < 0.01). With the increase of SBP, LV mass index (LVMI) and E/e stepwise increased and e ' stepwise decreased significantly from group 1 to 3 (all p < 0.05). In the whole population, SBP was independently correlated with LVMI, LVEDD, Left Atrial Volume Index, e ', and E/e ' (all p < 0.01). Conclusions SBP was independently related to LVH and LVDDF, SBP between 120 and 140mm Hg was independently related to worse LV remodelling and diastolic function, these findings indicated the potential benefit of intensive SBP control.
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关键词
cardiac epidemiology,hypertension,echocardiography
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