Abstract 17571: Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities (ARIC) Study
Background: Prehypertension (pre-HTN) is a highly prevalent condition associated with increased cardiovascular risk. The effects of prehypertension on cardiac structure and function in a large biracial cohort have not previously been described.
Methods: Our study is a cross sectional analysis of ARIC cohort participants during visit 5 (2011-2013). Participants with prevalent coronary heart disease, heart failure or prior myocardial infarction, and race other than black or white were excluded from this analysis. The final sample (n=4,647) was categorized in 3 groups: HTN (n=2,886; defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or prescribed antihypertensives), pre-HTN (n=1,099; 120 mmHg ≤ SBP<140mmHg or 80mmHg ≤DBP <90mmHg), and normal BP (n=662; SBP <120 mmHg and DBP <80 mmHg). Cardiac structure and function were assessed by 2D echocardiography. Variables were compared using ANOVA and X2 . Multivariable regression analyses were performed. A two-sided p-value <0.05 was considered significant.
Results: Participants with pre-HTN (62% female; mean age: 75 ± 5 y) had higher LV mass index and wall thicknesses than those with normal BP (63% female; mean age: 74 ± 5 y), but lower than those with HTN (61% female; mean age: 76 ± 5 y). In addition, participants with pre-HTN had impairments in the diastolic parameters E/A, E’ and E/E’ (all p<0.001) compared to those with normal BP (Table). All abnormalities of cardiac structure and function remained significant after adjustment for the following covariates: age, gender, race, heart rate, body mass index, diabetes, and eGFR.
Conclusions: In the ARIC cohort, pre-HTN was associated with increased concentric LV hypertrophy and impaired diastolic function even after adjusting for significant covariates. Clarifying the impact of pre-HTN on cardiac structure and function may help to better define future treatment strategies for this condition.
- © 2013 by American Heart Association, Inc.