Correlation Of Central Arterial Pressure With Left Cardiac Structure And Left Ventricular Diastolic Function In Postmenopausal Women With Hypertension

Background and purpose: Hypertension is an increasingly serious public health problem all over the world,and postmenopausal women with hypertension are at increased risk of cardiovascular disease and metabolic disorders due to the influence of gonadal hormone disorder and related pathological and physiological changes.A large number of studies have shown that blood pressure is one of the parameters that directly reflects the changes in the cardiovascular system,but different blood pressure measurements have different reflection in the time,severity and sensitivity of cardiovascular changes in hypertensive patients.This study evaluated the correlation of central arterial pressure(CAP)and peripheral blood pressure with the changes of left cardiac structure and left ventricular diastolic function in postmenopausal women with hypertension,and explored the assessment value of central arterial pressure on hypertension-mediated left cardiac structural and left ventricular diastolic functional damage.Methods: This study is a retrospective study.284 postmenopausal women with hypertension from the Hypertension Center of Lanzhou University Second Hospital who met the criteria of inclusion and exclusion were enrolled through the His system.and they were divided into the left ventricular diastolic dysfunction group(LVDD group)(n=125)and the normal left ventricular diastolic function group(NLVDD group)(n=159).The information of patients’ age,course of hypertension,treatment drugs,body mass index(BMI),biochemical data,urine and renal function results and peripheral brachial artery blood pressure were gathered;Ambulatory blood pressure monitoring(ABPM)related parameters include: 24-hour systolic pressure(24h SBP),24-hour diastolic blood pressure(24h DBP),daytime systolic pressure(d SBP),daytime diastolic blood pressure(d DBP),nighttime systolic pressure(n SBP),nighttime diastolic blood pressure(n DBP),morning systolic blood pressure(m SBP),morning diastolic blood pressure(m DBP),nighttime systolic blood pressure decrease,ambulatory arterial stiffness index(AASI);Sphygmocor pulse wave analysis system indirectly measured central systolic blood pressure(c SBP),central diastolic blood pressure(c DBP),pulse pressure(c PP),augmentation pressure(AP),central aortic pressure augmentation index(AIx).All patients were measured with echocardiography and recorded the left atrial diameter(LAD),left ventricular end diastolic dimension(LVEDd),interventricular septal thickness(IVST),the early peak flow velocity(E)and the early diastolic mitral valve annulus velocity(e’),etc.,take the average value,and calculate E/e’ and left ventricular mass index(LVMI).SPSS25.0 version was used for statistical analysis of the data of two groups.Results: 1.The general data comparison between the two groups: Among patients in the LVDD group(n=125)and NLVDD group(n=159),in the age,duration of hypertension,course of hypertension treatment,BMI,FPG,BUN,SCR,UA,CHO,TG,HDL,LDL,LVEF,LAD and LVMI,the difference was not statistically significant(P>0.05).There was a statistically significant difference in the levels of MAU,β2-MG,o SBP,c SBP,c PP,24 h SBP,d SBP,n SBP,m SBP,AASI,and E/e’between the two groups of patients(all P<0.05).2.Correlation analysis results showed: E/e’ and o SBP(r=0.319,P<0.05),c SBP(r=0.317,P<0.05),24 h SBP(r=0.306,P<0.05),d SBP(r=0.293,P<0.05),n SBP(r=0.274,P<0.05),m SBP(r=0.246,P<0.05)and MAU(r=0.314,P<0.05)are positively correlated;LVMI and o SBP(r=0.287,P<0.05),c SBP(r=0.298,P<0.05),c PP(r=0.319,P<0.05),c AP(r=0.278,P<0.05),24 h SBP(r= 0.309,P<0.05),d SBP(r=0.293,P < 0.05),n SBP(r=0.255,P < 0.05),m SBP(r=0.214,P < 0.05),MAU(r=0.334,P<0.05)and β2-MG(r=0.325,P<0.05)are positively correlated;LAD and o SBP(r=0.216,P<0.05),c SBP(r=0.185,P<0.05),c PP(r=0.199,P<0.05),c AP(r=0.194,P < 0.05),24 h SBP(r=0.274,P < 0.05),d SBP(r=0.263,P < 0.05),n SBP(r=0.253,P<0.05),m SBP(r=0.279,P<0.05)and MAU(r=0.283,P<0.05)are positively correlated.3.Multivariate Logistic regression analysis results: c SBP(β=0.526,P < 0.05)and c AP(β=-0.203,P<0.05)are independently related to left ventricular diastolic function;c SBP(β=-0.237,P<0.05)and c PP(β=0.189,P<0.05)are independently related to left atrial size.Conclusion: In postmenopausal women with hypertension,different blood pressure parameters such as CAP,o SBP,and ABPM are closely related to the left cardiac structure and left ventricular diastolic function.Compared with ABPM,CAP is more closely related to LAD and E/e’.The increase of CAP in postmenopausal women with hypertension may have a better role than peripheral blood pressure in evaluating hypertension-mediated left cardiac structural and left ventricular diastolic functional damage.