Abstract 2592: Left Ventricular Mass and Incident Arterial Hypertension in Subjects with Initial Optimal Blood Pressure: The Strong Heart Study.
Background: Metabolic abnormalities have been shown to predict incident arterial hypertension in normotensive young subjects followed for 15 years. Also LV mass has been reported as predictor of incident hypertension in subjects with high-normal blood pressure. There is no information on whether LV mass predicts arterial hypertension also in subjects with initial optimal blood pressure (BP), independent of metabolic confounders.
Methods: Participants from the Strong Heart Study (SHS) aged 57±7 years, with optimal BP (<120/80 mmHg) and without prevalent cardiovascular disease (n=713, 246 with diabetes, 477 women) underwent echocardiographic exam, lab tests and anthorpometric measurements.
Results: After 4 years, 138 subjects (91 women) were hypertensive (≥140/90 mmHg). They had higher baseline BMI, waist girth, BP (112/69 vs. 109/68 mmHg all p<0.008) than subjects remaining normotensive, with similar lipid profile. At baseline, LV mass (raw value or normalized for body surface area or height2.7 or fat-free mass) was significantly greater in subjects developing hypertension than in those remaining normotensive (all p<0.004), without difference in relative wall thickness. The difference in LV mass was confirmed after controlling for systolic BP and BMI (38.3±8.7 vs 36.3±7.4 g/m2.7, p<0.003) and was not affected by further adjustment for diabetes and plasma insulin levels or exclusion of diabetic participants. The risk of developing hypertension after 4 years increased by more than 10% for each 10 g increase in LV mass (p<0.003), independently of confounders, including sex, age, BMI, waist girth, BP, lipid profile, fasting glucose and presence of diabetes. Participants with LV mass>160 g (about 75th percentile of distribution) exhibited 2.52-fold higher adjusted risk of 4-year incident arterial hypertension than those below this value (95% onfidence interval: 1.57– 4.06).
Conclusions: LV mass is a potent predictor of incident arterial hypertension in subjects with initial optimal blood pressure. This effect is independent of body build, initial BP and metabolic profile.