Indices of Pulse Wave Analysis Are Better Predictors of Left Ventricular Mass Reduction Than Cuff Pressure

Junichiro Hashimoto, Yutaka Imai, Michael F. O'Rourke

Research output: Contribution to journalArticlepeer-review

111 Citations (Scopus)


Background: Studies have required large numbers of patients to associate regression of left ventricular (LV) mass with a decrease in brachial cuff blood pressure (BP) in the treatment of hypertension. Hence, we prospectively examined potential superiority of pulse wave analysis over conventional BP measurement in predicting treatment-induced LV mass reduction. Methods: Forty-six untreated patients (mean age, 56 ± 7 years) with hypertension received standard medical treatment based on international guidelines. Echocardiography and measurements of various LV load indices were made before and after 1 year of treatment. Results: Antihypertensive treatment significantly (P < .05) reduced LV load, manifest by a decrease in measured brachial BP, estimated aortic BP, carotid-femoral pulse wave velocity (PWVcf), aortic augmentation index (AIa), aortic augmented pressure (AugP), and radial augmentation index (AIr). These changes were accompanied by significant reduction in LV mass index (LVMI) and improvements in systolic ejection fraction and diastolic early-to-atrial ratio of transmitral flow velocities. The treatment-induced LVMI change was not correlated with changes in brachial BP or PWVcf, but was closely correlated with factors influenced by wave reflection-changes in AIa, AIr, AugP, and aorta-to-arm pulse pressure amplification. On multivariate analysis, AIa change was the strongest determinant of LVMI change, independent of brachial BP and PWVcf changes (β = 0.51, P < .001). Estimated subject numbers required for predicting a significant LVMI reduction were far less when wave reflection-related factors were used rather than conventional bracial BP. Conclusions: These results suggest that reduction in wave reflection is an important therapeutic strategy for reducing LV mass, which can be predicted with modest subject numbers.

Original languageEnglish
Pages (from-to)378-384
Number of pages7
JournalAmerican Journal of Hypertension
Issue number4
Publication statusPublished - 2007 Apr


  • Left ventricular mass
  • antihypertensive therapy
  • augmentation index
  • pulse wave
  • wave reflection

ASJC Scopus subject areas

  • Internal Medicine


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