Enhanced radial late systolic pressure augmentation in hypertensive patients with left ventricular hypertrophy

Junichiro Hashimoto, Daisuke Watabe, Rieko Hatanaka, Tomohiro Hanasawa, Hirohito Metoki, Kei Asayama, Takayoshi Ohkubo, Kazuhito Totsune, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

78 Citations (Scopus)

Abstract

Background: Wave reflection augments central blood pressure (BP) in late systole, thus increasing cardiac afterload. We examined the relationship between late systolic pressure augmentation in the peripheral radial artery pulse wave and the existence of left ventricular hypertrophy (LVH) in hypertension. Methods: Brachial BP, radial augmentation index (AIr), and carotid-femoral pulse wave velocity (PWVcf) were determined in 77 untreated hypertensive patients aged 56 ± 10 years. Cardiac structure and function were assessed by ultrasound, and LVH was defined based on the LV mass index (LVMI). Using multivariate analysis, patient characteristics were compared between those with (+) and without (-) LVH. Results: The LVMI was correlated independently and positively with AIr (β = 0.33, P = .004) and the brachial mean arterial pressure (MAP; β = 0.25, P = .03). The ratio of early to atrial peak velocities (E/A ratio) of the diastolic transmitral flow tended to be correlated negatively with the AIr. The LVH (+) group had a significantly higher AIr than the LVH (-) group [LVH (+), 97% v LVH (-), 89%, P = .003]; this difference remained significant even after adjustment for age, gender, MAP, and heart rate. The adjusted relative risk of LVH was 1.99 for each 10% AIr increase (P = .005). In contrast, LVMI was not correlated with the PWVcf, and the PWVcf was not different between the LVH (+) and LVH (-) groups. Moreover, there was no significant correlation between PWVcf and AIr. Conclusions: These results suggest that the peripheral AIr measurement is clinically useful in predicting LVH. Enhanced wave reflection may be related to the development of LVH in hypertensive patients.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalAmerican Journal of Hypertension
Volume19
Issue number1
DOIs
Publication statusPublished - 2006 Jan

Keywords

  • Augmentation index
  • Hypertension
  • Left ventricular hypertrophy
  • Radial pulse wave
  • Wave reflection

ASJC Scopus subject areas

  • Internal Medicine

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