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Implications of persistent prehypertension for ageing-related changes in left ventricular geometry and function: the MONICA/KORA Augsburg study.
Markus, Marcello Ricardo Paulista; Stritzke, Jan; Lieb, Wolfgang; Mayer, Björn; Luchner, Andreas; Döring, Angela; Keil, Ulrich; Hense, Hans-Werner; Schunkert, Heribert.
Afiliação
  • Markus MR; Medical Clinic II, University of Lübeck Medical School, Lübeck, Germany.
J Hypertens ; 26(10): 2040-9, 2008 Oct.
Article em En | MEDLINE | ID: mdl-18806629
ABSTRACT

BACKGROUND:

It is unclear whether persistent prehypertension causes structural or functional alterations of the heart.

METHODS:

We examined echocardiographic data of 1005 adults from a population-based survey at baseline in 1994/1995 and at follow-up in 2004/2005. We compared individuals who had either persistently normal (<120 mmHg systolic and <80 mmHg diastolic, n = 142) or prehypertensive blood pressure (120-139 mmHg or 80-89 mmHg, n = 119) at both examinations using multivariate regression modeling.

RESULTS:

Over 10 years, left ventricular end-diastolic diameters were stable and did not differ between the two groups. However, the prehypertensive blood pressure group displayed more pronounced ageing-related increases of left ventricular wall thickness (+4.7 versus +11.9%, P < 0.001) and left ventricular mass (+8.6 versus +15.7%, P = 0.006). Prehypertension was associated with a raised incidence of left ventricular concentric remodeling (adjusted odds ratio 10.7, 95% confidence interval 2.82-40.4) and left ventricular hypertrophy (adjusted odds ratio 5.33, 1.58-17.9). The ratio of early and late diastolic peak transmitral flow velocities (E/A) decreased by 7.7% in the normal blood pressure versus 15.7% in the prehypertensive blood pressure group (P = 0.003) and at follow-up the ratio of early diastolic peak transmitral flow and early diastolic peak myocardial relaxation velocities (E/EM) was higher (9.1 versus 8.5, P = 0.031) and left atrial size was larger (36.5 versus 35.3 mm, P = 0.024) in the prehypertensive blood pressure group. Finally, the adjusted odds ratio for incident diastolic dysfunction was 2.52 (1.01-6.31) for the prehypertensive blood pressure group.

CONCLUSIONS:

Persistent prehypertension accelerates the development of hypertrophy and diastolic dysfunction of the heart.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hipertrofia Ventricular Esquerda / Hipertensão Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans / Middle aged Idioma: En Ano de publicação: 2008 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hipertrofia Ventricular Esquerda / Hipertensão Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans / Middle aged Idioma: En Ano de publicação: 2008 Tipo de documento: Article