Abstract 13107: Left Ventricular Diastolic Function Evaluated by the E/e’ Ratio is Impaired in Patients With Masked Uncontrolled Hypertension
Background: Masked uncontrolled hypertension (MUH), defined as controlled office blood pressure (BP) but uncontrolled out-of-office BP in treated hypertensives, is a risk factor for cardiovascular disease. We tested the hypothesis that MUH is associated with a greater degree of diastolic dysfunction than controlled hypertension (CH) or uncontrolled hypertension (UH).
Methods and Results: We studied 344 treated patients who had at least one cardiovascular risk factor (age, 63±10 years; male sex, 42%), consisting of 107 (31.1%) patients with UH, 50 (14.5%) with MUH, 65 (18.3%) with treated white-coat hypertension (WCH), and 122 (35.4%) with CH. We performed office and home BP monitoring, electrocardiography, echocardiography, and blood tests. Diastolic dysfunction was defined as an E-wave to e’-wave (E/e’) ratio ≥ 8 measured by Doppler echocardiography.
The value of E/e’ was significantly higher in the MUH and UH groups than in the CH group (8.5±2.6, 8.2±2.9 vs. 7.3±2.2, respectively; P<0.05). In multivariable analysis, MUH was associated with a significantly higher risk of diastolic dysfunction (odds ratio 2.72 vs. CH, P<0.01) than CH after adjusting for significant covariates.
Conclusions: MUH and UH were associated with a greater degree of diastolic dysfunction than CH. Even in treated patients, out-of-office BP is important to stratify the risk of cardiovascular disease.
- © 2013 by American Heart Association, Inc.