Optimal Blood Pressure Control Improves Left Ventricular Torsional Deformation and Vascular Function in Newly Diagnosed Hypertensives: a 3-Year Follow-up Study

J Cardiovasc Transl Res. 2020 Oct;13(5):814-825. doi: 10.1007/s12265-019-09951-9. Epub 2020 Jan 2.

Abstract

We investigated the effects of optimizing blood pressure control on cardiac deformation and vascular function. For this purpose, in 200 untreated patients with essential hypertension, we assessed at baseline as well as after 3 years of optimal blood pressure control: arterial stiffness and coronary microcirculatory function as well as longitudinal and torsional deformation parameters. Compared to baseline, after 3 years of optimal blood pressure control, there was an improvement of longitudinal strain, twisting as well as untwisting parameters of the left ventricle. In parallel, there was an improvement in coronary microcirculatory function, arterial stiffness, left ventricular mass, and ventricular-arterial interaction. The reduction of arterial stiffness was independently associated with the respective improvement of cardiac deformation markers and coronary flow reserve after adjusting for blood pressure improvement. Blood pressure optimization improves LV longitudinal and torsional mechanics in hypertensives in parallel with arterial stiffness, resulting in improved ventricular-arterial interaction and coronary flow reserve. Trial registration: ClinicalTrials.gov Identifier: NCT02346695.

Keywords: Arterial stiffness; Coronary flow reserve; LV diastolic dysfunction; LV twisting and untwisting; Pulse wave velocity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Coronary Circulation / drug effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Male
  • Microcirculation / drug effects*
  • Middle Aged
  • Time Factors
  • Torsion Abnormality / diagnostic imaging
  • Torsion Abnormality / drug therapy*
  • Torsion Abnormality / physiopathology
  • Treatment Outcome
  • Vascular Stiffness / drug effects*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / drug therapy*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left / drug effects*

Substances

  • Antihypertensive Agents

Associated data

  • ClinicalTrials.gov/NCT02346695