Abstract 15301: Sustained Presence of Left Ventricular Hypertrophy is Accompanied by Increased Cardiovascular Morbidity in Essential Hypertensives
Hypothesis: To investigate the prognostic role of left ventricular hypertrophy (LVH) regression regarding incidence of cardiovascular diseasein essential hypertension.
Methods: We prospectively followed up for a median period of 3.8 years 1226 essential hypertensives (mean age 57.8 years, baseline office BP=143.6/89.3mmHg). All subjects visited periodically the outpatient hypertensive unit of our institution and office BP at follow up was calculated based on the measurements of the last 3 visits. Echocardiographic evaluation and determination of the metabolic profile and creatinine levels was performed at entry and at follow up. LVH was defined as LV mass index ≥116g/m2 in men and LV mass index ≥96g/m2 in women. Endpoint of interest was the incidence of stroke, coronary artery disease and their composite.
Results: At the end of follow up the incidence of the composite end-point was 4.0% (17 patients with stroke, 34 with CAD, 2 with both). According to the presence of LVH at baseline (20.2%) and at the end of follow-up (15.9%) patients were divided in two groups: with normal LV mass index at both examinations or with LVH at baseline and regression of hypertrophy (n=1031, 84.1%, group 1) and with LVH at baseline and at follow-up and with normal LV mass index at baseline and LVH at follow-up (n = 195, group 2). Hypertensives of group 2 compared to those of group 1 were older (by 6.3 years, p<0.001), more frequently females (by 19%, p<0.001) and had at baseline greater duration of hypertension (by 2.6 years, p<0.001), increased number of antihypertensive drugs (by 0.6, p<0.001) office pulse pressure levels (by 5mmHg, p<0.001), increased body mass index (by 0.8kg/m2, p=0.024), glucose (by 7.4 mg/dl, p<0.001) and decreased creatinine clearance (by 10.5 ml/min/, p<0.001).Survival analysis revealed that hypertensives without LVH regression (group 2) compared to those of group 1 exhibited significantly higher rates of stroke (5.1% vs. 0.7%, log rank p<0.001) and the composite end-point (7.7% vs. 3.3%, log rank p=0.020).
Conclusions: Lack of regression of LVH is accompanied by increased incidence of stroke and combined cardiovascular disease in essential hypertensives.
Author Disclosures: D. Tsiachris: None. C. Tsioufis: None. V. Antonakis: None. K. Dimitriadis: None. D. Flessas: None. F. Lagiou: None. S. Galanakos: None. A. Milkas: None. D. Roussos: None. D. Tousoulis: None.
- © 2015 by American Heart Association, Inc.