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 |
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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 |
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