Association of Office and Ambulatory Blood Pressure with Left Ventricular Structure and Function in Hypertensive Patients

Figures & data

Table 1 Baseline Characteristics

Variables	Overall (n=694)	Men (n=442)	Women (n=252)	P-value
Age (years)	62.9 ± 12.2	64.5 ± 13.8	60.6 ± 11.7	0.04
Body mass index (kg/m^2)	24.1 ± 5.2	24.6 ± 5.7	23.4 ± 4.7	0.17
Obesity, n (%)	108 (15.6)	73 (16.5)	35 (13.9)	0.09
Smoking, n (%)	162 (23.3)	147 (33.3)	15 (6.0)	<0.001
Dyslipidemia, n (%)	128 (18.4)	86 (19.5)	42 (16.7)	0.36
Diabetes mellitus, n (%)	201 (29.0)	130 (29.4)	71 (28.2)	0.90
Obstructive sleep apnea, n (%)	41 (5.9)	28 (6.3)	13 (5.2)	0.47
Fasting plasma glucose (mmo/L)	5.6 ± 0.6	5.6 ± 0.6	5.6 ± 0.5	0.95
TC (mmol/L)	5.0 ± 0.6	5.0 ± 0.5	5.1 ± 0.6	0.66
LDL-C (mmol/l)	3.2 ± 0.5	3.2 ± 0.6	3.3 ± 0.7	0.42
HDL-C (mmol/L)	1.0 ± 0.4	1.0 ± 0.4	1.0 ± 0.5	0.73
TG (mmol/L)*	1.7 (0.6–2.9)	1.6 (0.7–2.6)	1.8 (0.9–3.1)	0.02
eGFR (mL/min/1.73m^2)	78.9 ± 14.7	77.6 ± 15.4	80.3 ± 14.1	0.06
RASi, n (%)	388 (55.9)	250 (56.6)	138 (54.8)	0.52
Calcium channel blocker, n (%)	455 (65.6)	301 (69.1)	154 (59.5)	<0.001
Betablocker, n (%)	252 (36.3)	136 (30.8)	116 (46.0)	<0.001
Diuretic, n (%)	125 (18.0)	75 (17.0)	50 (19.8)	0.60
No. of antihypertensives	1.8 ± 0.5	1.9 ± 0.6	1.8 ± 0.5	0.78
Antiplatelets, n (%)	31 (4.5)	20 (4.5)	11 (4.4)	0.89
Antidiabetics, n (%)	183 (26.4)	116 (26.2)	67 (26.6)	0.56
Statins, n (%)	118 (17.0)	75 (17.0)	43 (17.1)	0.92

Note: *Presented as median (interquartile range).

Abbreviations: TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; eGFR, estimated glomerular filtration rate; RASi, renin-angiotensin-system inhibitor.

Figure 1 Study flowchart.

Table 2 Echocardiographic Parameters

Variables	Overall (n=694)	Men (n=442)	Women (n=252)	P-value
Cardiac structure
LAd (mm)	35.3 ± 3.4	36.8 ± 3.9	34.7 ± 3.0	0.08
LVESd (mm)	42.6 ± 5.8	44.7 ± 5.6	40.2 ± 4.5	0.005
LVEDd (mm)	50.2 ± 6.1	52.5 ± 6.3	49.1 ± 5.0	0.008
LVMi (g/m^2)	104.6 ± 13.6	108.3 ± 14.1	93.6 ± 12.7	<0.001
RWT	0.40 ± 0.08	0.41 ± 0.09	0.40 ± 0.06	0.78
LVH, n (%)	258 (37.2)	167 (37.9)	91 (36.1)	0.12
LV geometry				0.02
Normal, n (%)	352 (50.7)	219 (49.5)	133 (52.8)
Concentric remodeling, n (%)	84 (12.1)	56 (12.7)	33 (13.1)
Eccentric hypertrophy, n (%)	175 (25.2)	105 (23.8)	65 (25.8)
Concentric hypertrophy, n (%)	83 (12.0)	62 (14.0)	21 (8.3)
Cardiac function
LVEF (%)	64.8 ± 8.9	65.3 ± 9.7	64.2 ± 8.2	0.36
e’	9.4 ± 2.1	9.0 ± 2.0	9.5 ± 1.9	0.04
E/e’	8.3 ± 1.5	8.1 ± 1.2	8.5 ± 1.6	0.13

Abbreviations: LAd, Left atrial diameter; LVESd, left ventricular end systolic diameter; LVEDd, left ventricular end diastolic diameter; LVMi, left ventricular mass index; RWT, relative wall thickness; LVH, left ventricular hypertrophy; LVEF, left ventricular ejection fraction; LV, left ventricular.

Table 3 Parameters of OBP and 24h ABP

Variables	Overall (n=694)	Men (n=442)	Women (n=252)	P-value
Office SBP (mm Hg)	135.4 ± 12.6	136.1 ± 13.3	134.6 ± 13.0	0.15
Office DBP (mm Hg)	82.2 ± 8.4	83.4 ± 9.6	81.9 ± 7.5	0.33
24h SBP (mm Hg)	130.2 ± 10.8	132.6 ± 11.3	129.3 ± 10.0	0.04
24h DBP (mm Hg)	78.5 ± 8.7	80.3 ± 10.1	77.6 ± 7.9	0.07
Daytime SBP (mm Hg)	134.9 ± 11.6	136.6 ± 12.9	132.8 ± 9.5	0.01
Daytime DBP (mm Hg)	80.6 ± 9.2	82.3 ± 11.1	79.2 ± 8.4	0.09
Nighttime SBP (mm Hg)	126.6 ± 7.5	130.3 ± 9.2	125.1 ± 6.6	0.008
Nighttime DBP (mm Hg)	76.1 ± 6.2	78.0 ± 7.5	75.3 ± 6.0	0.10
Non-dipping pattern, n (%)	226 (32.6)	153 (34.6)	73 (29.0)	0.04
Reverse dipper, n (%)	104 (15.0)	74 (16.7)	30 (11.9)	0.007

Abbreviations: OBP, office blood pressure; ABP, ambulatory blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Table 4 Association Between OBP and 24h ABP with LVMi and e’ Velocity

	Overall (n=694)	Men (n=442)	Women (n=252)	P-value for Interaction
LVMi	β-Coefficient (95% confidence interval)
Office SBP	3.48 (1.79 to 6.05)	3.61 (2.04 to 6.36)	3.25 (1.51 to 5.93)	0.11
Office DBP	1.65 (−0.11 to 3.56)	1.84 (−0.38 to 4.80)	1.33 (−0.25 to 2.79)	0.62
24h SBP	6.11 (2.45 to 8.32)	7.88 (3.62 to 9.80)	5.32 (1.86 to 7.64)	<0.001
24h DBP	2.43 (−0.56 to 5.04)	3.03 (−0.79 to 6.16)	2.16 (−0.48 to 4.92)	0.25
Daytime SBP	4.61 (2.08 to 7.32)	5.89 (3.35 to 8.64)	3.97 (2.11 to 7.07)	0.005
Daytime DBP	1.67 (−0.34 to 3.02)	1.75 (−0.48 to 4.15)	1.32 (−0.25 to 2.91)	0.40
Nighttime SBP	7.03 (4.14 to 9.62)	7.43 (4.68 to 9.94)	6.32 (3.23 to 8.01)	0.002
Nighttime DBP	3.23 (−0.84 to 5.16)	4.25 (−0.92 to 5.83)	2.78 (−0.66 to 4.59)	0.09
Non-dipping pattern	3.38 (1.21 to 5.45)	4.64 (2.43 to 6.93)	2.99 (1.03 to 5.21)	0.01
Reverse dipper	3.90 (2.01 to 6.23)	5.02 (2.45 to 7.01)	3.06 (1.89 to 5.88)	0.03
e’ velocity	β-Voefficient (95% confidence interval)
Office SBP	2.12 (1.34 to 4.21)	2.51 (1.42 to 5.32)	2.00 (1.26 to 4.23)	0.18
Office DBP	1.46 (−0.32 to 3.27)	1.90 (−0.46 to 4.26)	1.37 (−0.31 to 3.82)	0.46
24h SBP	5.68 (2.21 to 7.60)	6.14 (2.88 to 8.35)	4.96 (2.05 to 7.07)	0.003
24h DBP	2.23 (−0.41 to 4.26)	3.11 (−0.56 to 5.89)	2.02 (−0.35 to 4.01)	0.37
Daytime SBP	4.09 (2.00 to 6.39)	5.28 (2.31 to 7.62)	3.76 (1.89 to 6.06)	0.02
Daytime DBP	1.90 (−0.46 to 3.31)	2.02 (−0.59 to 4.22)	1.67 (−0.38 to 3.05)	0.29
Nighttime SBP	6.62 (3.89 to 8.43)	7.37 (4.07 to 8.86)	6.14 (3.06 to 7.89)	0.01
Nighttime DBP	3.34 (−0.76 to 5.33)	4.29 (−0.80 to 5.76)	3.01 (−0.67 to 4.78)	0.59
Non-dipping pattern	3.10 (1.29 to 5.09)	4.36 (2.17 to 6.25)	2.67 (1.11 to 5.26)	0.007
Reverse dipper	3.54 (1.98 to 4.66)	4.01 (2.18 to 5.02)	3.12 (1.77 to 4.21)	0.02

Note: Adjusted for age, obesity, diabetes mellitus, obstructive sleep apnea, estimated glomerular filtration rate and antihypertensive drugs.

Abbreviations: LVMi, left ventricular mass index; OBP, office blood pressure; ABP, ambulatory blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Table 5 Association Between OBP and 24h ABP with LVH

	Overall (n=694)	Men (n=442)	Women (n=252)	P-value for Interaction
LVH	Odds ratio (95% confidence interval)
Office SBP	1.16 (1.04–1.29)	1.20 (1.09–1.38)	1.11 (1.01–1.22)	0.24
Office DBP	1.05 (0.94–1.15)	1.10 (0.98–1.21)	1.02 (0.90–1.12)	0.37
24h SBP	1.23 (1.12–1.40)	1.31 (1.18–1.52)	1.18 (1.09–1.38)	0.006
24h DBP	1.18 (0.97–1.32)	1.24 (0.95–1.36)	1.10 (0.98–1.27)	0.11
Daytime SBP	1.27 (1.18–1.47)	1.33 (1.21–1.57)	1.22 (1.15–1.44)	0.009
Daytime DBP	1.10 (0.96–1.17)	1.15 (1.01–1.22)	1.04 (0.91–1.11)	0.14
Nighttime SBP	1.29 (1.16–1.51)	1.36 (1.20–1.57)	1.23 (1.21–1.55)	0.01
Nighttime DBP	1.14 (0.97–1.28)	1.17 (0.95–1.25)	1.08 (0.93–1.18)	0.42
Non-dipping pattern	1.33 (1.18–1.57)	1.40 (1.25–1.63)	1.29 (1.13–1.48)	0.002
Reverse dipper	1.42 (1.20–1.64)	1.50 (1.33–1.68)	1.36 (1.14–1.57)	0.01

Note: Adjusted for age, obesity, diabetes mellitus, obstructive sleep apnea, estimated glomerular filtration rate and antihypertensive drugs.

Abbreviations: LVH, left ventricular hypertrophy; OBP, office blood pressure; ABP, ambulatory blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure.