Abstract 12284: Cumulative Blood Pressure in Early Adulthood and Cardiac Dysfunction in Middle Age: Coronary Artery Risk Development in Young Adults (CARDIA) Study
Background: Cumulative blood pressure (BP) exposure from young adulthood to middle age may adversely influence myocardial function and predispose individuals to heart failure later in life. Our main objective is to investigate how cumulative exposure to high BP influences left ventricular (LV) function in the first half of the human lifespan.
Methods: Coronary Artery Risk Development in Young Adults (CARDIA) prospectively enrolled 5,115 healthy 18-30 year old African Americans and Whites in 1985-1986 (baseline). After 25 Years (43-55 years), LV function was measured by 2D echocardiograms, including cardiac deformation by speckle tracking echocardiography (STE). We cumulated BP exposure from baseline through Year-25 (mmHgхyear). Linear and logistic regression were used in 2479 participants to quantify the association of cumulative BP with LV myocardial function assessed by STE at middle age. All coefficients are per standard deviation.
Results: Systolic function: cumulative BP measures were not related to LV ejection fraction (LVEF); however, high cumulative exposure to either systolic BP (SBP) or diastolic BP (DBP) were independently associated with lower longitudinal strain rate (standardized β-coefficient of SBP=0.086 and DBP=0.107 for longitudinal strain rate, both p<0.001). Diastolic function: cumulative exposure to either SBP or DBP was independently associated with low early diastolic longitudinal peak strain rate, and high E/e’ ratio. Importantly, DBP had the stronger association with diastolic dysfunction, defined as E/e’ ratio >15 (odds ratio[OR]= 1.69, 95% confidence interval[CI]= 1.23-2.33) compared to SBP (OR = 1.46, CI = 1.09-1.94) (Table).
Conclusions: Cumulative exposure to BP over 25 years from young adulthood to middle age is associated with LV systolic and diastolic dysfunction in middle age.
Author Disclosures: S. Kishi: None. G. Teixido-Tura: None. H. Ning: None. B.A. Venkatesh: None. C. Wu: None. A. Almeida: None. E. Choi: None. O. Gjesdal: None. C. Cox: None. D.R. Jacobs: None. P.J. Schreiner: None. S. Gidding: None. K. Liu: None. J.A. Lima: Research Grant; Significant; Toshiba Medical Systems.
- © 2014 by American Heart Association, Inc.