Abstract 21577: Prevalence and Relations of Echocardiographic Biomarkers of Newly Diagnosed Systemic Hypertension
Background: Little is known regarding the temporal relationship of the development of increased LV mass, LA enlargement, and diastolic abnormalities. We aimed to evaluate the prevalence of LV mass increase, LA enlargement, and diastolic dysfunction in newly diagnosed systemic hypertension and naïve to drug treatment.
Methods: In this prospective study, we identified adult patients of age ≥18 years who were newly diagnosed with systemic hypertension from outpatient care settings (BP > 140/90 mm Hg on at least 2 non-acute situations). Exclusion criteria were history and/or evidence of diabetes, coronary artery disease, atrial fibrillation, stroke, transient ischemic attack, heart failure, myocardial infarction, sleep apnea, valvular heart disease and treatment with any antihypertensive medications for >2 weeks.
Results: Of the 162 patients identified, 24 were not included in the analyses because of the presence of exclusion criteria. The prevalence of left atrial (LA) enlargement (at least mild, >29 mL/m2 by biplane area-length method), LV diastolic dysfunction (at least grade 1 diastolic dysfunction by conventional grading system using Doppler assessment, and/or tissue Doppler evidence of septal e' of <0.08 m/sec), and increased LV mass (>125 g/m2 in men and >110 g/m2 in women) were evaluated. The mean age of the 138 patients (75 men, 63 women) was 64 ±13 years. The distribution of racial ethnic origin is as follows: 60 Caucasians, 56 Chinese, 10 South Asians, and 12 others. Of the 138 patients, 90 (65%) had LA enlargement only, 4 (3%) had increased LV mass only, 38(28%) had both LA enlargement and increased LV mass, and 6(4)% had neither. Notably, 92% of the study population had at least tissue Doppler and/or Doppler evidence of diastolic dysfunction.
Conclusion: In an ethnically diverse population, LV diastolic dysfunction was evident in the vast majority of patients with newly diagnosed systemic hypertension and naïve to antihypertensive drug therapy. At least mild LA enlargement was highly prevalent, and elevated LV mass was not common. These findings suggested the possibility that physiologic changes that can be characterized by tissue Doppler/Doppler assessment occur before structural remodeling of atrium and ventricle.
- © 2010 by American Heart Association, Inc.