International Journal of General Medicine (Jul 2021)

Effects of Different Systolic Blood Pressure Targets on Myocardial Function: A One-Year Follow-Up in Geriatric Hypertension

  • Chen X,
  • Yang Q,
  • Fang J,
  • Guo H

Journal volume & issue
Vol. Volume 14
pp. 3775 – 3785

Abstract

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Xiaoyan Chen,1 Qingmei Yang,1 Jianxiu Fang,1 Haifeng Guo2 1Department of Ultrasound, Shanxi Bethune Hospital & Shanxi Academy of Medical Sciences, Taiyuan, Shanxi Province, People’s Republic of China; 2Department of Medical Imaging, Shanxi Armed Police Force Hospital, Taiyuan, Shanxi Province, People’s Republic of ChinaCorrespondence: Xiaoyan ChenDepartment of Ultrasound, Shanxi Bethune Hospital & Shanxi Academy of Medical Sciences, Taiyuan, Shanxi Province, People’s Republic of ChinaTel +8613934200119Email [email protected]: A lower systolic blood pressure (SBP) target reduces major cardiovascular events and mortality from any cause of geriatric hypertension. However, the effect of different SBP targets on myocardial function remains unclear. This study aimed to determine changes in left ventricular (LV) strain in older hypertensive patients after 1 year of different SBP goals, and to evaluate its effects on myocardial mechanics in this population.Methods: We studied 313 hypertensive adults aged 60 years or older after 1 year of the Systolic Blood Pressure Intervention Trial. They were divided into the intensive group (target SBP: 110– 130 mmHg) and the standard group (target SBP: 130– 150 mmHg). All participants underwent echocardiography within 1 week after enrollment and 1 year after participating in the study. Global longitudinal strain (GLS) of the LV (endocardial, middle, and epicardial layer: GLS-end, GLS-mid, and GLS-epi, respectively) and the improvement of GLS at 1 year (ΔGLS-end, ΔGLS-mid, and ΔGLS-epi) were measured.Results: At 1 year, GLS-end in the intensive group was slightly improved compared with that before the trial (− 23.78%± 3.10% vs − 22.58%± 3.11%, P< 0.05). The ΔGLS-end and ΔGLS-mid in the intensive group were higher than those in the standard group (1.20± 0.23 vs 0.58± 0.59% and 0.70± 0.21 vs 0.52± 0.17, P< 0.05). Moreover, SBP at 1 year and an angiotensin II type 1 receptor antagonist were independent factors that affected ΔGLS-end (β= − 0.005, P=0.004; β= 0.080, P< 0.001, respectively).Conclusion: These trial results suggest that a lower SBP target can slightly improve myocardial function in older hypertensive patients at 1 year.Keywords: hypertension, blood pressure target, elder population, strain, left ventricular function

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