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Original article
Midlife blood pressure predicts future diastolic dysfunction independently of blood pressure
  1. Arjun Kumar Ghosh1,2,
  2. Alun David Hughes3,
  3. Darrel Francis1,
  4. Nishi Chaturvedi3,
  5. Denis Pellerin2,
  6. John Deanfield3,
  7. Diana Kuh4,
  8. Jamil Mayet1,
  9. Rebecca Hardy4
  10. on behalf of the MRC NSHD Scientific and Data Collection Team
  1. 1International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College, London, UK
  2. 2Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
  3. 3Institute of Cardiovascular Science, University College London, London, UK
  4. 4Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
  1. Correspondence to Dr Arjun Kumar Ghosh, Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK; a.ghosh{at}imperial.ac.uk

Abstract

Objectives High blood pressure (BP) is associated with diastolic dysfunction, but the consequence of elevated BP over the adult life course on diastolic function is unknown. We hypothesised that high BP in earlier adulthood would be associated with impaired diastolic function independent of current BP.

Methods Participants in the Medical Research Council National Survey of Health and Development birth cohort (n=1653) underwent investigations including echocardiography at age 60–64 years. The relationships between adult BP, antihypertensive treatment (HTT) and echocardiographic measures of diastolic function were assessed using adjusted regression models.

Results Increased systolic BP (SBP) at ages 36, 43 and 53 years was predictive of increased E/e′ and increased left atrial volume. These effects were only partially explained by SBP at 60–64 years and increased left ventricular mass. HTT was also associated with poorer diastolic function after adjustment for SBP at 60–64 years. Faster rates of increase in SBP in midlife were also associated with increased poorer diastolic function.

Conclusions High SBP in midlife is associated with poorer diastolic function at age 60–64 years. Early identification of individuals with high BP or rapid rises in BP may be important for prevention of impaired cardiac function in later life.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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