Abstract 16342: Suboptimal Blood Pressure Control as an Independent Risk Factor of Early Impaired Left Ventricular Myocardial Function in Treated Hypertensive Patients
Introduction: Early impairment of left ventricular (LV) myocardial function has been observed in hypertension before the development of heart failure symptoms. However, it remains unclear if the poor blood pressure (BP) control status contributes to further reduction of LV function.
Methods: This study enrolled 186 consecutive patients from a hypertension clinic who had been receiving BP-lowering medication, and 42 matched healthy subjects. The BP of systolic<140mmHg and diastolic<90mmHg was defined as optimal control (Group 1, n=93), otherwise as suboptimal (Group 2, n=93). The mean systolic longitudinal (εLs-18), circumferential (εCs-18) and radial strain (εRs-18) among the 18 LV segments were computed, while the cutoff value (mean-1.96SD) from the normal group was adopted to define an impaired LV strain.
Results: Despite matched age and gender, Group 2 had a further reduction of εLs-18 (18.3±1.9 vs. 16.6±1.9%), εCs-18 (19.8±2.1 vs. 17.8±2.3%) or εRs-18 (21.7±3.0 vs. 19.1±2.8%) (all p<0.001) than Group 1. Impairment of εLs-18 was observed in 110 (59%) patients with 40 (43%) in Group 1 and 70 (75%) in Group 2. The figures for εCs-18 and εRs-18 were 88 (47%), 27 (29%), 61 (66%), and 29 (16%), 5(5%), 24 (26%), respectively. Impaired myocardial function of all the 3 components was found in 18 (10%) patients. In a multivariate logistic regression model created to identify the associated factors of the εLs-18 impairment, the suboptimal BP control (Odds ratio (OR) 5.076, p<0.001) and female gender (OR 0.345, p<0.01) appeared significant. In contrast, age, body mass index, presence of diabetes or hyperlipidemia, LV hypertrophy and left atrial volume index were not (all p>0.05).
Conclusions: Early impairment of LV myocardial function assessed by two-dimensional speckle tracking could be attributed to suboptimal BP control. It appeared to be an independent risk factor which might be a composite index of several adverse processes occurred in hypertension.
- © 2013 by American Heart Association, Inc.