Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study
We tested the prognostic impact of a marker of arterial stiffness, pulse pressure/stroke volume index (PP/SVi), in patients with hypertension and left ventricular (LV) hypertrophy. We used data from 866 patients randomized to losartan or atenolol-based antihypertensive treatment, over a median of 4....
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2017-05-01
|
| Series: | Blood Pressure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08037051.2016.1243009 |
| _version_ | 1797685074541412352 |
|---|---|
| author | Costantino Mancusi Eva Gerdts Giovanni de Simone Helga Midtbø Mai Tone Lønnebakken Kurt Boman Kristian Wachtell Björn Dahlöf Richard B. Devereux |
| author_facet | Costantino Mancusi Eva Gerdts Giovanni de Simone Helga Midtbø Mai Tone Lønnebakken Kurt Boman Kristian Wachtell Björn Dahlöf Richard B. Devereux |
| author_sort | Costantino Mancusi |
| collection | DOAJ |
| description | We tested the prognostic impact of a marker of arterial stiffness, pulse pressure/stroke volume index (PP/SVi), in patients with hypertension and left ventricular (LV) hypertrophy. We used data from 866 patients randomized to losartan or atenolol-based antihypertensive treatment, over a median of 4.8 years, in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. The association of PP/SVi with outcomes was tested in Cox regression analyses and reported as hazard ratio (HR) and 95% confidence intervals (CI). In multivariate regression, reduction of PP/SVi was independently associated with male gender, reduction in systolic blood pressure (BP) and relative wall thickness and with an increase in left ventricular ejection fraction (all p < .05). After adjusting for confounders, higher baseline PP/SVi predicted a 38% higher hazard of combined major fatal and non-fatal cardiovascular events (95% CI 1.04–1.84), and higher hazard of cardiovascular mortality (HR 2.35 (95% CI 1.59–3.48) and stroke (HR 1.45 (95% CI 1.06–1.99) (all p < .05). Higher PP/SVi also predicts higher rate of hospitalization for HF (HR 2.15 (95% CI 1.48–3.12) and a 52% higher hazard of all-cause mortality (95% CI 1.10–2.09) (both p < .05). In hypertensive patients with electrocardiographic LV hypertrophy, higher PP/SVi was associated with increased cardiovascular morbidity and mortality. |
| first_indexed | 2024-03-12T00:40:13Z |
| format | Article |
| id | doaj.art-5a2bea31fa4e48c9a891e16abda06af3 |
| institution | Directory Open Access Journal |
| issn | 0803-7051 1651-1999 |
| language | English |
| last_indexed | 2024-03-12T00:40:13Z |
| publishDate | 2017-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Blood Pressure |
| spelling | doaj.art-5a2bea31fa4e48c9a891e16abda06af32023-09-15T08:45:21ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992017-05-0126315015510.1080/08037051.2016.12430091243009Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE studyCostantino Mancusi0Eva Gerdts1Giovanni de Simone2Helga Midtbø3Mai Tone Lønnebakken4Kurt Boman5Kristian Wachtell6Björn Dahlöf7Richard B. Devereux8University of BergenUniversity of BergenHypertension Research Center, Federico II University HospitalUniversity of BergenUniversity of BergenUniversity of UmeaaGentofte HospitalSahlgrenska University Hospital/ÖstraWeill Medical College of Cornell UniversityWe tested the prognostic impact of a marker of arterial stiffness, pulse pressure/stroke volume index (PP/SVi), in patients with hypertension and left ventricular (LV) hypertrophy. We used data from 866 patients randomized to losartan or atenolol-based antihypertensive treatment, over a median of 4.8 years, in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. The association of PP/SVi with outcomes was tested in Cox regression analyses and reported as hazard ratio (HR) and 95% confidence intervals (CI). In multivariate regression, reduction of PP/SVi was independently associated with male gender, reduction in systolic blood pressure (BP) and relative wall thickness and with an increase in left ventricular ejection fraction (all p < .05). After adjusting for confounders, higher baseline PP/SVi predicted a 38% higher hazard of combined major fatal and non-fatal cardiovascular events (95% CI 1.04–1.84), and higher hazard of cardiovascular mortality (HR 2.35 (95% CI 1.59–3.48) and stroke (HR 1.45 (95% CI 1.06–1.99) (all p < .05). Higher PP/SVi also predicts higher rate of hospitalization for HF (HR 2.15 (95% CI 1.48–3.12) and a 52% higher hazard of all-cause mortality (95% CI 1.10–2.09) (both p < .05). In hypertensive patients with electrocardiographic LV hypertrophy, higher PP/SVi was associated with increased cardiovascular morbidity and mortality.http://dx.doi.org/10.1080/08037051.2016.1243009arterial stiffnesshypertensioncardiovascular eventsprognosis |
| spellingShingle | Costantino Mancusi Eva Gerdts Giovanni de Simone Helga Midtbø Mai Tone Lønnebakken Kurt Boman Kristian Wachtell Björn Dahlöf Richard B. Devereux Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study Blood Pressure arterial stiffness hypertension cardiovascular events prognosis |
| title | Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study |
| title_full | Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study |
| title_fullStr | Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study |
| title_full_unstemmed | Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study |
| title_short | Higher pulse pressure/stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the LIFE study |
| title_sort | higher pulse pressure stroke volume index is associated with impaired outcome in hypertensive patients with left ventricular hypertrophy the life study |
| topic | arterial stiffness hypertension cardiovascular events prognosis |
| url | http://dx.doi.org/10.1080/08037051.2016.1243009 |
| work_keys_str_mv | AT costantinomancusi higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT evagerdts higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT giovannidesimone higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT helgamidtbø higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT maitonelønnebakken higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT kurtboman higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT kristianwachtell higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT bjorndahlof higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy AT richardbdevereux higherpulsepressurestrokevolumeindexisassociatedwithimpairedoutcomeinhypertensivepatientswithleftventricularhypertrophythelifestudy |