| Initial left-ventricular mass predicts probability of uncontrolled blood pressure in arterial hypertension. | |
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MedLine Citation:
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PMID: 21297500 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Journal of hypertension Volume: 29 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-10 Completed Date: 2011-07-01 Revised Date: 2011-08-29 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 803-8 Citation Subset: IM |
Affiliation:
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Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, and Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Pressure* Female Heart Ventricles / physiopathology* Humans Hypertension / pathology*, physiopathology Male Middle Aged Organ Size Probability |
| Comments/Corrections | |
Comment In:
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J Hypertens. 2011 Aug;29(8):1661-2
[PMID:
21750439
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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