Relation of Blood Pressure Components to Left Ventricular Hypertrophy and Coronary Heart Disease with Aging

Park, Jae Suk; Park, Chang Gyu; Park, Mi Young; Park, Jae Hyoung; Kim, Yong Hyun; Na, Jin Oh; Shin, Sung Hee; Suh, Soon Yong; Hong, Soon Jun; Park, Sung Mi; Lim, Hong Euy; Kim, Eung Joo; Seo, Hong Seok; Oh, Dong Joo; Ro, Young Moo

Abstract

BACKGROUND AND OBJECTIVES
There is still uncertainty regarding the relative importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) in predicting the risk of cardiovascular disease. The relative importance of the BP components, as markers of left ventricular hypertrophy (LVH) and coronary artery disease (CAD), were examined in relation to age.
SUBJECTS AND METHODS
In 257 subjects receiving no antihypertensive medication, LVH was determined using the M-mode echocardiography when left ventricular mass index (LVMI) was >or =129 g/m2 in men or >or =118 g/m2 in women. In a further 265 subjects, CAD was determined using the coronary angiography when stenosis of the coronary arterial diameter was >or =70%. The most important BP component was determined using a logistic regression analysis.
RESULTS
With respect to LVH, in the group <0 years of age, odds ratios (ORs) per 10 mmHg increment in BP were 2.47 (p<.01), 1.77 (p<.01), 1.30 (p>0.10) for DBP, SBP and PP respectively. In the group 50 to 59 years of age, ORs were 1.65, 1.35, 1.36 (all p<.05) for DBP, SBP and PP respectively. In the group >or =60 years of age, ORs were 1.56 (p<.05), 1.67, 2.17 (both p<.01) for DBP, SBP and PP respectively. With respect to CAD, in all age group, ORs were 0.93 (p>0.10), 1.07 (p>0.10), 1.21 (p<.05) for DBP, SBP and PP respectively. In the group >or =60 years of age, no BP component had a statistical significance.
CONCLUSION
With increasing age, there was a gradual shift from DBP to SBP and then to PP as the marker with the greatest relation to LVH. In all age group, PP was the strongest marker of CAD.