Am J Cardiovasc Dis 2012;2(4):309-317

Original Article
Subclinical, hemodynamic, and echocardiographic abnormalities of high
pulse pressure in hypertensive and non-hypertensive adults

Stephen P Glasser, Tatiana Krasikov, Richard B Devereux, Albert Oberman, Amit Patki, Dalane W Kitzman, DC Rao, Donna
K Arnett

University of Alabama at Birmingham, AL; New York Presbyterian Hospital-Weill Medical College of Cornell University, New
York, NY; Wake Forest University School of Medicine, Winston-Salem, NC; Washington University, St. Louis, MO

Received August 1, 2012; accepted September 29, 2012; Epub October 25, 2012; Published November 15, 2012

Abstract: Background: High pulse pressure (PP) is associated with cardiovascular events, but subclinical abnormalities in
cardiac structure and function in relation to high pulse pressure are not well described. Methods and Results: 2225
hypertensive and 1380 non-hypertensive participants with adequate echocardiographic left ventricular measurements were
evaluated. Non-hypertensives in the highest PP tertile (compared to the lower tertiles) were older (44 years vs. 40 years,
p<0.009), had higher systolic pressure [(SBP) 136 mmHg vs. 108 mmHg] and lower diastolic pressure [(DBP) 54 vs. 71
mmHg (p=.0001)], greater BMI (27 vs. 25 kg/m2, p<.001) and more diabetes (4% vs. 2.25%, p<.001). In the hypertensive
group, subjects in the highest PP tertile were older (52 vs 42 years), had higher SBP (157 vs. 116 mmHg) but lower DBP
(65 vs. 83 mmHg). In the non-hypertensive group, higher PP (>60 mmHG) was associated with a higher frequency of
echocardiographic structural and functional abnormalities, specifically, greater posterior and relative wall thickness, longer
isovolumic relaxation time, and concentric left ventricular (LV) hypertrophy. Conclusion: In a population-based sample of
hypertensive and non-hypertensive participants, higher PP was associated with subclinical abnormalities of cardiac
structure and function, which exist even in the absence of hypertension and/or the use of antihypertensive treatment.

Keywords: Left ventricular hypertrophy, pulse pressure, hypertension, arterial stiffness, echocardiography

Address all correspondence to:
Dr. Stephen P Glasser
University of Alabama at Birmingham
1717 11th Avenue South, MT638
Birmingham, AL 35205.
Tel: (205) 975-7125; Fax: (205) 975-5199
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