INFLUENCE OF CONTEMPORARY VERSUS 30-YEAR BLOOD-PRESSURE LEVELS ON LEFT-VENTRICULAR MASS AND GEOMETRY - THE FRAMINGHAM HEART-STUDY

To determine whether long-term blood pressure levels correlate with left ventricular mass, echocardiographic measurements were performed in 152 men and 299 women who were participants in the Framingham Heart Study. All subjects were free of obesity and cardiovascular and pulmonary disease, were not taking antihypertensive medications and had echocardiographic studies that were adequate for estimating left ventricular mass. Thirty-year average systolic blood pressure was correlated with left ventricular mass (corrected for height) (r = 0.27, p < 0.001 in men; r = 0.31, p < 0.001 in women). Multivariate linear regression analyses taking into account age and body mass index showed 30-year average systolic blood pressure to be a significant independent predictor of left ventricular mass (p < 0.01 in men and women). Systolic blood pressure at echocardiography was not independently associated with left ventricular mass when 30-year systolic blood pressure was entered into the multivariate model. The prevalence of left ventricular hypertrophy was associated with 30-year average systolic blood pressure (odds ratio for every 20-mm Hg increase in blood pressure: 3.20, p < 0.05 in men; 3.27, p < 0.001 in women). The increase in left ventricular mass associated with 30-year average systolic blood pressure reflected changes in left ventricular wall thickness but not in left ventricular internal dimension. Thirty-year average diastolic blood pressure was also correlated with left ventricular mass but to a lesser degree than was systolic blood pressure (r = 0.18, p < 0.05 in men; r = 0.18, p < 0.01 in women). It is concluded that long-term blood pressure levels are correlated with left ventricular mass and wall thickness but not with left ventricular internal dimension. Thirty-year average systolic blood pressure is a better predictor of left ventricular mass and wall thickness than is current rest blood pressure. Both current and long-term systolic blood pressures are better predictors of left ventricular mass and wall thickness than are current and long-term values for diastolic blood pressure.