Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients
Abstract Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial en...
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| Veröffentlicht in: | Blood pressure 2013-02, Vol.22 (1), p.39-44 |
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| creator | Armario, Pedro Oliveras, Anna Hernández-Del-Rey, Raquel Suárez, Carmen Martell, Nieves Ruilope, Luis M. Sierra, Alejandro De La |
| description | Abstract
Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial enlargement (LAE) is less known. This cross-sectional study assessed the factors associated with LAE, with special focus on blood pressure (BP) estimates obtained by ambulatory blood pressure monitoring (ABPM), in 250 patients with RH, aged 64 ± 11 years. LAE and LVH were observed in 10.0% (95% CI 6.3-13.7) and 57.1% (95% CI 50.8-63.5) of patients, respectively. Compared with patients with normal atrium size, those exhibiting LAE were older, more frequently women, had elevated pulse pressure (PP) measured both at the office and by ABPM, and showed higher prevalence of LVH (83% vs 54%; p = 0.016). In a logistic regression analysis, adjusting for age, gender, body mass index, left ventricular mass index and BP pressure estimates, night-time PP was independently associated with LAE (OR for 5 mmHg = 1.28, 95% CI 1.24-1.32; p = 0.001). In conclusion, besides classical determinants of LAE, such as age and LVH, an elevated night-time PP was independently associated with LAE in patients with RH. |
| doi_str_mv | 10.3109/08037051.2012.701789 |
| format | Article |
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Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial enlargement (LAE) is less known. This cross-sectional study assessed the factors associated with LAE, with special focus on blood pressure (BP) estimates obtained by ambulatory blood pressure monitoring (ABPM), in 250 patients with RH, aged 64 ± 11 years. LAE and LVH were observed in 10.0% (95% CI 6.3-13.7) and 57.1% (95% CI 50.8-63.5) of patients, respectively. Compared with patients with normal atrium size, those exhibiting LAE were older, more frequently women, had elevated pulse pressure (PP) measured both at the office and by ABPM, and showed higher prevalence of LVH (83% vs 54%; p = 0.016). In a logistic regression analysis, adjusting for age, gender, body mass index, left ventricular mass index and BP pressure estimates, night-time PP was independently associated with LAE (OR for 5 mmHg = 1.28, 95% CI 1.24-1.32; p = 0.001). In conclusion, besides classical determinants of LAE, such as age and LVH, an elevated night-time PP was independently associated with LAE in patients with RH.</description><identifier>ISSN: 0803-7051</identifier><identifier>EISSN: 1651-1999</identifier><identifier>DOI: 10.3109/08037051.2012.701789</identifier><identifier>PMID: 23305454</identifier><language>eng</language><publisher>England: Informa Healthcare</publisher><subject>Age Factors ; Aged ; Ambulatory blood pressure monitoring ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Body Mass Index ; Circadian Rhythm ; Cross-Sectional Studies ; Female ; Heart Atria - pathology ; Heart Atria - physiopathology ; Humans ; Hypertension - pathology ; Hypertension - physiopathology ; Hypertrophy, Left Ventricular - pathology ; Hypertrophy, Left Ventricular - physiopathology ; left atrial enlargement ; Male ; Middle Aged ; pulse pressure ; resistant hypertension ; Sex Factors</subject><ispartof>Blood pressure, 2013-02, Vol.22 (1), p.39-44</ispartof><rights>2013 Scandinavian Foundation for Cardiovascular Research 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-17be933db0214c8c332f69e078e31e5bc42a80c5fb2a4dde4113da35fdf5e3343</citedby><cites>FETCH-LOGICAL-c418t-17be933db0214c8c332f69e078e31e5bc42a80c5fb2a4dde4113da35fdf5e3343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23305454$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Armario, Pedro</creatorcontrib><creatorcontrib>Oliveras, Anna</creatorcontrib><creatorcontrib>Hernández-Del-Rey, Raquel</creatorcontrib><creatorcontrib>Suárez, Carmen</creatorcontrib><creatorcontrib>Martell, Nieves</creatorcontrib><creatorcontrib>Ruilope, Luis M.</creatorcontrib><creatorcontrib>Sierra, Alejandro De La</creatorcontrib><creatorcontrib>Investigators of Resistant Hypertension Registry of the Spanish Society of Hypertension</creatorcontrib><title>Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients</title><title>Blood pressure</title><addtitle>Blood Press</addtitle><description>Abstract
Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial enlargement (LAE) is less known. This cross-sectional study assessed the factors associated with LAE, with special focus on blood pressure (BP) estimates obtained by ambulatory blood pressure monitoring (ABPM), in 250 patients with RH, aged 64 ± 11 years. LAE and LVH were observed in 10.0% (95% CI 6.3-13.7) and 57.1% (95% CI 50.8-63.5) of patients, respectively. Compared with patients with normal atrium size, those exhibiting LAE were older, more frequently women, had elevated pulse pressure (PP) measured both at the office and by ABPM, and showed higher prevalence of LVH (83% vs 54%; p = 0.016). In a logistic regression analysis, adjusting for age, gender, body mass index, left ventricular mass index and BP pressure estimates, night-time PP was independently associated with LAE (OR for 5 mmHg = 1.28, 95% CI 1.24-1.32; p = 0.001). In conclusion, besides classical determinants of LAE, such as age and LVH, an elevated night-time PP was independently associated with LAE in patients with RH.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Ambulatory blood pressure monitoring</subject><subject>Blood Pressure</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Body Mass Index</subject><subject>Circadian Rhythm</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Heart Atria - pathology</subject><subject>Heart Atria - physiopathology</subject><subject>Humans</subject><subject>Hypertension - pathology</subject><subject>Hypertension - physiopathology</subject><subject>Hypertrophy, Left Ventricular - pathology</subject><subject>Hypertrophy, Left Ventricular - physiopathology</subject><subject>left atrial enlargement</subject><subject>Male</subject><subject>Middle Aged</subject><subject>pulse pressure</subject><subject>resistant hypertension</subject><subject>Sex Factors</subject><issn>0803-7051</issn><issn>1651-1999</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EokvhHyDkI5ds_ZUmuYBQBbRSJS5wtibOmHXlfOBxqPbf19G2SFx6Gll-3ndGD2PvpdhrKboL0QrdiFrulZBq3wjZtN0LtpOXtaxk13Uv2W5Dqo05Y2-I7oSQWgvxmp2pMmtTmx3zN5NLCIQDX9ZIyJeERGtCHogD0ewC5PJ5H_KBR_SZQ04BIscpQvqNI06Zh4mXVKAM5XE4LpgyThT-ljbIoRD0lr3yUOrfPc5z9uvb159X19Xtj-83V19uK2dkmyvZ9NhpPfRCSeNap7Xylx2KpkUtse6dUdAKV_tegRkGNFLqAXTtB1-j1kafs4-n3iXNf1akbMdADmOECeeVrFRNoYyWqqDmhLo0EyX0dklhhHS0UtjNsH0ybDfD9mS4xD48blj7EYd_oSelBfh8AsLk5zTC_ZziYDMc45x8gskF2uqfXfHpv4YDQswHBwnt3bymqQh8_sYHWH2f3Q</recordid><startdate>201302</startdate><enddate>201302</enddate><creator>Armario, Pedro</creator><creator>Oliveras, Anna</creator><creator>Hernández-Del-Rey, Raquel</creator><creator>Suárez, Carmen</creator><creator>Martell, Nieves</creator><creator>Ruilope, Luis M.</creator><creator>Sierra, Alejandro De La</creator><general>Informa Healthcare</general><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201302</creationdate><title>Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients</title><author>Armario, Pedro ; Oliveras, Anna ; Hernández-Del-Rey, Raquel ; Suárez, Carmen ; Martell, Nieves ; Ruilope, Luis M. ; Sierra, Alejandro De La</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-17be933db0214c8c332f69e078e31e5bc42a80c5fb2a4dde4113da35fdf5e3343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Ambulatory blood pressure monitoring</topic><topic>Blood Pressure</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>Body Mass Index</topic><topic>Circadian Rhythm</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Heart Atria - pathology</topic><topic>Heart Atria - physiopathology</topic><topic>Humans</topic><topic>Hypertension - pathology</topic><topic>Hypertension - physiopathology</topic><topic>Hypertrophy, Left Ventricular - pathology</topic><topic>Hypertrophy, Left Ventricular - physiopathology</topic><topic>left atrial enlargement</topic><topic>Male</topic><topic>Middle Aged</topic><topic>pulse pressure</topic><topic>resistant hypertension</topic><topic>Sex Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Armario, Pedro</creatorcontrib><creatorcontrib>Oliveras, Anna</creatorcontrib><creatorcontrib>Hernández-Del-Rey, Raquel</creatorcontrib><creatorcontrib>Suárez, Carmen</creatorcontrib><creatorcontrib>Martell, Nieves</creatorcontrib><creatorcontrib>Ruilope, Luis M.</creatorcontrib><creatorcontrib>Sierra, Alejandro De La</creatorcontrib><creatorcontrib>Investigators of Resistant Hypertension Registry of the Spanish Society of Hypertension</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood pressure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Armario, Pedro</au><au>Oliveras, Anna</au><au>Hernández-Del-Rey, Raquel</au><au>Suárez, Carmen</au><au>Martell, Nieves</au><au>Ruilope, Luis M.</au><au>Sierra, Alejandro De La</au><aucorp>Investigators of Resistant Hypertension Registry of the Spanish Society of Hypertension</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients</atitle><jtitle>Blood pressure</jtitle><addtitle>Blood Press</addtitle><date>2013-02</date><risdate>2013</risdate><volume>22</volume><issue>1</issue><spage>39</spage><epage>44</epage><pages>39-44</pages><issn>0803-7051</issn><eissn>1651-1999</eissn><abstract>Abstract
Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial enlargement (LAE) is less known. This cross-sectional study assessed the factors associated with LAE, with special focus on blood pressure (BP) estimates obtained by ambulatory blood pressure monitoring (ABPM), in 250 patients with RH, aged 64 ± 11 years. LAE and LVH were observed in 10.0% (95% CI 6.3-13.7) and 57.1% (95% CI 50.8-63.5) of patients, respectively. Compared with patients with normal atrium size, those exhibiting LAE were older, more frequently women, had elevated pulse pressure (PP) measured both at the office and by ABPM, and showed higher prevalence of LVH (83% vs 54%; p = 0.016). In a logistic regression analysis, adjusting for age, gender, body mass index, left ventricular mass index and BP pressure estimates, night-time PP was independently associated with LAE (OR for 5 mmHg = 1.28, 95% CI 1.24-1.32; p = 0.001). In conclusion, besides classical determinants of LAE, such as age and LVH, an elevated night-time PP was independently associated with LAE in patients with RH.</abstract><cop>England</cop><pub>Informa Healthcare</pub><pmid>23305454</pmid><doi>10.3109/08037051.2012.701789</doi><tpages>6</tpages></addata></record> |
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| subjects | Age Factors Aged Ambulatory blood pressure monitoring Blood Pressure Blood Pressure Monitoring, Ambulatory Body Mass Index Circadian Rhythm Cross-Sectional Studies Female Heart Atria - pathology Heart Atria - physiopathology Humans Hypertension - pathology Hypertension - physiopathology Hypertrophy, Left Ventricular - pathology Hypertrophy, Left Ventricular - physiopathology left atrial enlargement Male Middle Aged pulse pressure resistant hypertension Sex Factors |
| title | Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients |
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