Impact of pulse pressure on degree of cardiac hypertrophy in patients with chronic uraemia

Objective To evaluate the degree of cardiac hypertrophy in patients with end-stage renal disease (ESRD) in comparison with that in patients with uncomplicated hypertension and in patients with peripheral vascular disease (PVD), at the same values of mean blood pressure. Design Thirty-six ambulatory hypertensive patients were investigated, 11 with ESRD, 14 with PVD and 11 with uncomplicated hypertension, matched for age, sex, mean arterial pressure and antihypertensive drug treatment. Methods Cardiac mass was determined using M-mode echocardiography together with measurement of systemic blood pressure and the ratio between ankle and arm systolic blood pressures. Results At the same mean arterial pressure, patients with ESRD developed a greater degree of cardiac hypertrophy in comparison with those with uncomplicated hypertension (P<0.01) and patients with PVD (P<0.05). The pulse pressure was significantly greater in patients with ESRD than in those with uncomplicated hypertension (P<0.01) and those with PVD (P<0.05). Multiple regression analysis showed that only pulse pressure was positively correlated to cardiac mass (r=0.62, P<0.001), suggesting a predominant impact of pulse pressure on left ventricular mass in patients with ESRD. Conclusions In patients with chronic uraemia, left ventricular hypertrophy seems to be strongly and independently associated with pulse pressure. J Hypertens 18:1645-1650 (C) 2000 Lippincott Williams & Wilkins.