Abstract 216: Left Ventricular Diastolic Dyssynchrony In Patients With Treatment-naïVe Hypertension And The Effects Of Antihypertensive Therapy
Backgrounds: We tried to investigate whether differ in various blood pressure (BP) parameters between the patients with low normal TSH and high normal TSH levels.
Methods: The study groups consisted of 285 patients with treatment-naïve hypertension and euthryoid undergoing comprehensive echocardiography (TTE), brachial-ankle pulse wave velocity (PWV), ankle-brachial index, central BPs, and ambulatory BP monitoring (ABPM) evaluations. All patients were divided into those with low normal TSH (0.40~1.99 μIU/ml, group 1) or high-normal TSH (2.00-4.50 μIU/ml, group 2).
Results: Hypertensive male patients were divided into group 1 (n=113, 68.9%) and group 2 (n=51, 31.1%) and female patients were divided into group 1 (n=71, 58.7%) and group 2 (n=50, 41.3%). Multivariate analyses revealed augmentation index (AIx, 71.0 [adjusted mean]±1.7 [standard error] vs. 78.8±2.5 %, p=0.045), central systolic BP (SBP) (143.3±2.1 vs. 153.0±3.2 mmHg, p=0.013), systemic vascular resistance (21.4±0.6 vs. 23.9±0.9 mmHg/L/min, p=0.027), and SBP in daytime (144.1±1.4 vs. 151.6±2.1 mmHg, p=0.004) and nighttime (130.4±1.6 vs. 138.5±2.5 mmHg, p=0.008), and nighttime pulse pressure (PP, 47.2±0.9 vs. 51.7±1.4 mmHg, p=0.010) were significantly higher and cardiac output (5.4±0.1 vs. 4.8±0.2 L/min, p=0.043) and PP amplification (1.02±0.02 vs. 0.94±0.03, p=0.039) were significantly lower in male group 2. After multivariate analyses, SBP (β=0.225, p=0.010) and PP (β=0.179, p=0.022) at office, PWV (β=0.192, p=0.036), AIx (β=0.285, p=0.007), central SBP (β=0.351, p=0.001), DBP (β=0.246, p=0.012), and PP (β=0.317, p=0.006), SBP in daytime (β=0.219, p=0.004) and nighttime (β=0.232, p=0.013), and PP in 24-hour (β=0.216, p=0.005) and nighttime (β=0.172, p=0.024) were linearly associated with levels of TSH in hypertensive male.
Conclusion: Despite euthryoid, arterial stiffness, central SBP, and SBP in ABPM are higher and cardiac output and PP amplification are lower in high normal TSH group of treatment-naïve hypertensive male, but not female. Arterial stiffness, SBP and PP at office, central BPs, and SBP and PP in ABPM are linearly associated with TSH levels among hypertensive male.
Author Disclosures: B. Kwon: None. R. Woong: None. H. Kim: None. S. Ihm: None.
- © 2014 by American Heart Association, Inc.