Static and pulsatile blood pressure correlates of left ventricular structure and function in black and white young adults: The CARDIA study

Objective To determine the unbiased relative strength of the association of static (systolic and diastolic) and pulsatile (pulse pressure) blood pressure components with left ventricular mass and function. Background Blood pressure is correlated with left ventricular moss; however, the unbiased relative strength of static and pulsatile blood pressure components with left ventricular mass and function is unknown in young adults. Methods Cross-sectional analyses of 3918 young adult participants at 4 community-based CARDIA clinical centers during 1990 and 1991. Results Left ventricular mass positively correlated (P < .01) with systolic, diastolic, and pulse pressure in all ethnicity-sex groups except for diastolic blood pressure in white men (P = .19). The association rank ordered as systolic blood pressure > pulse pressure > diastolic blood pressure except in white men, in whom pulse pressure and systolic blood pressure reversed positions in this hierarchy. Systolic blood pressure was the third and fourth strongest independent correlate of left ventricular mass in men and women, respectively. Body mass index, followed by height, was the strongest correlate of left ventricular mass in both sexes. Left ventricular wall thickness/chamber radius ratio positively correlated with diastolic and systolic blood pressure (women only) (P < .05) but not with pulse pressure. In all groups, stroke volume positively correlated (P < .05) with pulse pressure but was unrelated to static blood pressure measures, except for systolic blood pressure in black men. Left ventricular mass and the ventricular wall thickness/chamber radius ratio were greater in blacks compared with whites. Conclusions Although systolic blood pressure was consistently the strongest unbiased blood pressure correlate of left ventricular mass, this relation varied by ethnicity and sex Pulse pressure correlated with favorable left ventricular function and geometry, suggesting an opposite meaning to the ominous prognosis of wide pulse pressure in hypertensive, older adults.