Do treatment-induced changes in arterial stiffness affect left ventricular structure? A meta-analysis

Autor: Maarten H. G. Heusinkveld, Koen M van der Waaij, Koen D. Reesink, Abraham A. Kroon, Tammo Delhaas
Rok vydání: 2019
Předmět:
COMMON CAROTID-ARTERY
medicine.medical_specialty
Physiology
Heart Ventricles
Blood Pressure
BLOOD-PRESSURE
Pulse Wave Analysis
ANTIHYPERTENSIVE TREATMENT
030204 cardiovascular system & hematology
Left ventricular hypertrophy
AORTIC ELASTIC PROPERTIES
THERAPY
Muscle hypertrophy
PULSE-WAVE
03 medical and health sciences
Vascular Stiffness
0302 clinical medicine
Internal medicine
Internal Medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
ventricular-vascular coupling
Pulse wave velocity
Antihypertensive Agents
HYPERTENSION
business.industry
aging
medicine.disease
Hypertensive heart disease
left ventricular hypertrophy
HYPERTROPHY
Blood pressure
Heart failure
Meta-analysis
Arterial stiffness
Cardiology
HEART-FAILURE
Hypertrophy
Left Ventricular

diastolic dysfunction
ASCENDING AORTA
hypertensive heart disease
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Hypertension. 37:253-263
ISSN: 0263-6352
DOI: 10.1097/hjh.0000000000001918
Popis: Background: Vascular research demonstrated that pulse wave velocity (PWV), a measure of arterial stiffness, is inherently blood pressure dependent. Considering the hypothesized pathophysiological chain of increased arterial stiffness leading to increased blood pressure load with consequent left ventricular hypertrophy (LVH) development, we conducted a systematic review of antihypertensive and lifestyle intervention studies to determine the association between, on the one hand, changes in arterial stiffness and blood pressure, and, on the other hand, changes in left ventricular mass (LVM). Methods: Using PubMed, EMBASE, Cochrane and Web of Science, we identified 23 studies, containing 2573 patients. Studies reported changes in arterial stiffness (assessed by means of PWV), SBP, DBP and LVM index (LVMI), respectively. Results: Statistically significant reductions in SBP, PWV and LVMI were reported in 16, 14 and 20 studies, respectively. Pooled analysis of studies showed that the proportion in SBP reduction did not correlate significantly to the proportion in reductions of the other two variables. On the contrary, we found a significant positive correlation (r = 0.61, P = 0.003) between arterial stiffness and reduction of LVM, expressed as a relevant reduction in LVMI of 6.9 g/m(2) per 1.0 m/s reduction in PWV. Conclusion: Our findings provide evidence that a decrease in arterial stiffness is associated with reduction of LVM. To investigate whether there exists a causal relation between LVH due to arterial stiffness increases and in turn blood pressure load increases, future studies should strive for a multiple follow-up design and use of blood pressure independent or corrected stiffness indices.
Databáze: OpenAIRE