The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease
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Date
2017
Authors
O'Flynn, Anne Marie
Ho, Emily
Dolan, Eamon
Curtin, Ronan J.
Kearney, Patricia M.
Journal Title
Journal ISSN
Volume Title
Publisher
Lippincott, Williams & Wilkins
Published Version
Abstract
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.
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Keywords
Ambulatory blood pressure monitoring , Carotid intima-media thickness , Global longitudinal strain , Hypertension , Ultrasonography
Citation
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