The Relationship Between Left Atrial Diameter Index And Blood Pressure Variability In Patients With Essential Hypertension

ObjectiveLeft atrial enlargement promoting the development of thrombogenesis and atrial fibrillation is an important cause of ischemic stroke around the world.There is roughly 29.6% hypertension,32% of which is undergoing left atrial enlargement.on the other hand,there is almost 100 million people with hypertension and left atrial enlargement around the world.To investigate the relationship between left atrial diameter index(LADi)and blood pressure variability(BPV)in patients with essential hypertension.MethodsAccording to the cut point corresponding to the 95 th percentile in PAMELA study,a total of 212 hypertensive patients were enrolled and divided into two groups(LADi>24 mm/m,n=47;LADi≤24 mm/m,n=165).Demographics and baseline parameters(smoking,sex,age,height,weight,blood fat,fasting blood glucose,renal function),blood pressure,BPV and standardized heart echocardiogram were measured in all patients.The correlation analysis and multiple linear regression analysis were performed to identify the independent determinants of enlarging LADi in patients with hypertension.ResultsThere were significant difference between two groups in 24 hSBP,24hDBP,wsd24 hSBP,wsd24hDBP,nocturnal systolic blood pressure fall,nocturnal diastolic blood pressure fall(indexes of BPV),left ventricular mass indexed for body surface(LVMi)(r=0.187,0.141,0.265,0.253,0.461,0.415,-0.196,-0.162,0.313,all P<0.05).The correlation analysis indicated that age,BMI,FBG,24 hSBP,24hDBP,24 hSSD,24hDSD,wsd24 hSBP,wsd24hDBP,ST-MSBPS,ST-MDBPS,LVMi positively correlated to LADi(r=0.259,0.157,0.188,0.187,0.141,0.265,0.253,0.461,0.415,0.235,0.209,0.313,all P<0.05),while nocturnal systolic blood pressure fall,nocturnal diastolic blood pressure fall were negative(r=-0.196,-0.162,all P<0.05).The multiple linear regression revealed that wsd24hSBP(B=0.241,P<0.01),wsd24hDBP(B=0.239,P<0.01),24hSSD(B=0.124,P<0.01),24hDSD(B=0.117,P<0.01),ST-MSBPS(B=0.024,0.028,all P<0.01),ST-MDBPS(B=0.025,P>0.05;B=0.029,P<0.05)(indexes of BPV)and LVMi(B=0.031,0.026,0.029,0.026,all P<0.01)were positively and significantly correlated with LADi.ConclusionIn the present study,we demonstrated that 24 hSSD,24hDSD,ST-MSBPS,ST-MDBPS,especially wsd24 hSBP and wsd24 hDBP were independently associated with LADi.