Satoru Kishi1, Gisela Teixido-Tura2, Hongyan Ning3, Bharath Ambale Venkatesh1, Colin Wu4, Andre Almeida1, Eui-Young Choi1, Ola Gjesdal1, David R Jacobs5, Pamela J Schreiner5, Samuel S Gidding6, Kiang Liu3, João A C Lima7. 1. Division of Cardiology, Johns Hopkins University, Baltimore, Maryland. 2. Department of Cardiology, Hospital Vall d'Hebron, Barcelona, Spain. 3. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 4. Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland. 5. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota School of Public Health, Minneapolis, Minnesota. 6. Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware. 7. Division of Cardiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: jlima@jhmi.edu.
Abstract
BACKGROUND: Cumulative blood pressure (BP) exposure may adversely influence myocardial function, predisposing individuals to heart failure later in life. OBJECTIVES: This study sought to investigate how cumulative exposure to higher BP influences left ventricular (LV) function during young to middle adulthood. METHODS: The CARDIA (Coronary Artery Risk Development in Young Adults) study prospectively enrolled 5,115 healthy African Americans and whites in 1985 and 1986 (baseline). At the year 25 examination, LV function was measured by 2-dimensional echocardiography; cardiac deformation was assessed in detail by speckle-tracking echocardiography. We used cumulative exposure of BP through baseline and up to the year 25 examination (millimeters of mercury × year) to represent long-term exposure to BP levels. Linear regression and logistic regression were used to quantify the association of BP measured repeatedly through early adulthood (18 to 30 years of age) up to middle age (43 to 55 years). RESULTS: Among 2,479 participants, cumulative BP measures were not related to LV ejection fraction; however, high cumulative exposure to systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with lower longitudinal strain rate (both p < 0.001). For diastolic function, higher cumulative exposures to SBP and DBP were associated with low early diastolic longitudinal peak strain rate. Of note, higher DBP (per SD increment) had a stronger association with diastolic dysfunction compared with SBP. CONCLUSIONS: Higher cumulative exposure to BP over 25 years from young adulthood to middle age is associated with incipient LV systolic and diastolic dysfunction in middle age.
BACKGROUND: Cumulative blood pressure (BP) exposure may adversely influence myocardial function, predisposing individuals to heart failure later in life. OBJECTIVES: This study sought to investigate how cumulative exposure to higher BP influences left ventricular (LV) function during young to middle adulthood. METHODS: The CARDIA (Coronary Artery Risk Development in Young Adults) study prospectively enrolled 5,115 healthy African Americans and whites in 1985 and 1986 (baseline). At the year 25 examination, LV function was measured by 2-dimensional echocardiography; cardiac deformation was assessed in detail by speckle-tracking echocardiography. We used cumulative exposure of BP through baseline and up to the year 25 examination (millimeters of mercury × year) to represent long-term exposure to BP levels. Linear regression and logistic regression were used to quantify the association of BP measured repeatedly through early adulthood (18 to 30 years of age) up to middle age (43 to 55 years). RESULTS: Among 2,479 participants, cumulative BP measures were not related to LV ejection fraction; however, high cumulative exposure to systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with lower longitudinal strain rate (both p < 0.001). For diastolic function, higher cumulative exposures to SBP and DBP were associated with low early diastolic longitudinal peak strain rate. Of note, higher DBP (per SD increment) had a stronger association with diastolic dysfunction compared with SBP. CONCLUSIONS: Higher cumulative exposure to BP over 25 years from young adulthood to middle age is associated with incipient LV systolic and diastolic dysfunction in middle age.
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Authors: Silvio Henrique Barberato; Minna Moreira Dias Romano; Adenalva Lima de Souza Beck; Ana Clara Tude Rodrigues; André Luiz Cerqueira de Almeida; Bruna Morhy Borges Leal Assunção; Eliza de Almeida Gripp; Fabio Villaça Guimarães Filho; Henry Abensur; José Maria Del Castillo; Marcelo Haertel Miglioranza; Marcelo Luiz Campos Vieira; Márcio Vinicius Lins de Barros; Maria do Carmo Pereira Nunes; Maria Estefania Bosco Otto; Renato de Aguiar Hortegal; Rodrigo Bellio de Mattos Barretto; Thais Harada Campos; Vicente Nicoliello de Siqueira; Samira Saady Morhy Journal: Arq Bras Cardiol Date: 2019-08-08 Impact factor: 2.000