Document Detail


Initial left-ventricular mass predicts probability of uncontrolled blood pressure in arterial hypertension.
MedLine Citation:
PMID:  21297500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left-ventricular hypertrophy (LVH) is a marker of organ damage in hypertension and helps stratifying cardiovascular risk. Initial left-ventricular mass (LVM) is also a predictor of progression to hypertension, independently of initial blood pressure (BP) and other confounders.
OBJECTIVES: To evaluate whether baseline LVM can influence BP control in treated hypertension.
METHODS: We evaluated risk of uncontrolled BP (>140 or 90 mmHg under at least two medications), in relation to initial LVM in 4693 hypertensive outpatients (mean age 53±11 years, 43% women, 5% diabetic), without prevalent cardiovascular disease, from the Campania Salute Network.
RESULTS: Uncontrolled BP was found in 2240 patients (48%). Participants with initial LVH were more often men, older, diabetic, had higher initial BP, fasting glucose, uric acid and triglycerides, and lower heart rate (HR), high-density lipoprotein-cholesterol and glomerular filtration rate than those without LVH (all P<0.05). Of 1440 patients with initial LVH, 803 (56%) were uncontrolled at follow-up compared to 44% without LVH (P<0.0001). In multivariate analyses, odds of uncontrolled BP increased with higher baseline systolic BP [odds ratio (OR)=1.13×5 mmHg, 95% confidence interval (CI) 1.10-1.15], HR (OR=1.04×5 beats/min, 95% CI 1.01-1.07), BMI (OR=1.03×kg/m, 95% CI 1.01-1.04), LVM index (OR=1.05×5 g/m, 95% CI 1.01-1.10) and prevalence of diabetes (OR=5.22, 95% CI 3.52-7.76; all P<0.05) independently of age, sex, metabolic parameters and number of antihypertensive meds (P>0.1). Among medication classes, only angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were associated with lower risk of uncontrolled BP (OR=0.83, 95% CI 0.71-0.96; P=0.01), independently of covariates.
CONCLUSION: In a population of treated hypertensive patients, initial LVM is a significant predictor of uncontrolled BP, independently of major risk factors and antihypertensive therapy.
Authors:
Raffaele Izzo; Giovanni de Simone; Richard B Devereux; Renata Giudice; Marina De Marco; Claudia S Cimmino; Antonio Vasta; Nicola De Luca; Bruno Trimarco
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  29     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-10     Completed Date:  2011-07-01     Revised Date:  2011-08-29    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  803-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, and Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure*
Female
Heart Ventricles / physiopathology*
Humans
Hypertension / pathology*,  physiopathology
Male
Middle Aged
Organ Size
Probability
Comments/Corrections
Comment In:
J Hypertens. 2011 Aug;29(8):1661-2   [PMID:  21750439 ]

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