Abstract 143 Correlation of systolic and diastolic blood pressure with echocardiographic phenotypes of cardiac structure and function Results from three German population-based studies

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Correlation of systolic and diastolic blood pressure with echocardiographic phenotypes of cardiac structure and function Results from three German population-based studies
J. Nikorowitsch¹, R. Bei der Kellen¹, A. Haack¹, C. Magnussen¹, J. Prochaska², P. S. Wild³, M. Dörr⁴, R. Twerenbold¹, R. Schnabel¹, P. Kirchhof¹, S. Blankenberg¹, M. R. P. Markus⁴, J. Wenzel¹, für die Studiengruppen: HCHS, GHS, SHIP
¹Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ²Zentrum für Kardiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz; ³Präventive Kardiologie und Medizinische Prävention, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz; ⁴Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald;
Background: Arterial hypertension is considered as a risk factor for the development of heart failure. The association of systolic (SBP) and diastolic blood pressure (DBP) with functional and morphologic phenotypes of left-sided cardiac structure and function needs to be further elucidated. Aim: We investigated associations of SBP and DBP with functional and morphological echocardiographic measures in three German representative samples of the general population. Methods and Results: We assessed four echocardiographic parameters of left-ventricular (LV) function and morphology (for hypertrophy, LV mass; for volume, LV enddiastolic volume; for systolic function, LV ejection fraction; for diastolic function, E/e’ mean ratio) in 7,396 participants of the Hamburg City Health Study (HCHS) after exclusion of subjects with symptomatic heart failure (51.8% female, median age 62 [IQR: 55; 69] years). Multivariable linear regression analyses with SBP and DBP as continuous predictors were adjusted for common cardiovascular risk factors and antihypertensive medication. Results were validated in 19,323 participants from the Study of Health in Pomerania and from the Gutenberg Health Study. In HCHS, median SBP was 137.0 [IQR: 125.5, 150.5] millimeters of mercury (mmHg) and median DBP 82.0 [75.5, 88.0] mmHg. SBP and DBP were consistently directly associated with measures of LV hypertrophy. SBP correlated with diastolic dysfunction and DBP with systolic dysfunction in all cohorts. Detailed results correlating cardiac phenotypes with blood pressures in each cohort respectively are displayed in the figure. Conclusions: Continuous systolic and diastolic blood pressures are both associated with left ventricular hypertrophy in three independent adult German population samples whereas their associations with LV echocardiographic parameters of cardiac function differ. Figure. Forest plot of multivariable linear regression analysis of systolic and diastolic blood pressure as predictor and LV measures as outcome in subjects without heart failure from the Hamburg City Health Study (HCHS, blue), Gutenberg Health Study (GHS, red) and the Study of Health in Pomerania (SHIP, green). Adjustment was performed for age, sex, BMI, smoking, coronary artery disease (prevalent myocardial infarction in GHS), diabetes, atrial fibrillation, and antihypertensive medication. Abbreviations: CI = confidence interval
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