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The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease
O'Flynn, Anne Marie; Ho, Emily; Dolan, Eamon; Curtin, Ronan J.; Kearney, Patricia M.
Introduction The aim of this study was to examine the association of night-time systolic blood pressure (BP) with subclinical cardiac dysfunction measured by global longitudinal strain (GLS) and subclinical vascular damage measured by carotid intima-media thickness (CIMT) and carotid plaques. Methods GLS was measured by speckle-tracking analysis of echocardiogram images. CIMT was measured at the distal 1 cm of the common carotid artery. The presence of carotid plaques was recorded. Philips QLAB cardiac and vascular ultrasound quantification software was used for analysis. The association of night-time systolic BP with GLS, CIMT and carotid plaques was assessed using linear and logistic regression. Results Fifty (response rate 63%) individuals took part in this study. In univariable models, night-time systolic BP was significantly associated with GLS [beta coefficient 0.85 for every 10 mmHg increase, 95% confidence interval (CI): 0.3-1.4] and carotid plaques (odds ratio 1.9 for every 10 mmHg increase, 95% CI: 1.1-3.2). Univariable analysis of daytime systolic BP did not show any statistically significant associations. In age-adjusted and sex-adjusted models, the association for night-time systolic BP and GLS remained significant (beta coefficient 0.68 for every 10 mmHg increase, 95% CI: 0.1-1.3). The association for carotid plaques was no longer statistically significant. In multivariable models, findings were diminished. Discussion Our results suggest a trend towards an association between night-time systolic BP and subclinical cardiac and vascular disease. When assessing ambulatory blood pressure monitoring results, the absolute night-time systolic BP seems to be a better prognostic parameter than daytime systolic BP, but ultimately a large randomised controlled trial involving chronotherapy is necessary to fully address this. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
Keyword(s): Ambulatory blood pressure monitoring; Carotid intima-media thickness; Global longitudinal strain; Hypertension; Ultrasonography
Publication Date:
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University College Cork
Funder(s): Health Research Board
Citation(s): O’Flynn, A. M., Ho, E., Dolan, E., Curtin, R. J. and Kearney, P. M. (2017) 'The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease', Blood Pressure Monitoring, 22(1), pp. 18-26. doi: 10.1097/MBP.0000000000000223
Publisher(s): Lippincott, Williams & Wilkins
File Format(s): application/pdf
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First Indexed: 2018-06-16 06:30:38 Last Updated: 2018-07-13 06:31:05