Key result
Hypertension linked to increased myocardial fibrosis indicators including higher collagen volume fraction.
Why the study?
Hypertension is a major risk factor for myocardial fibrosis, but the relationship needed comprehensive evaluation using data from imaging and histological studies.
Is hypertension associated with myocardial fibrosis, and do specific antihypertensive medications attenuate this fibrosis?
Meta-Analysis (n=45,776)
Is hypertension associated with myocardial fibrosis, and do specific antihypertensive medications attenuate this fibrosis?
Hypertension is significantly associated with myocardial fibrosis, which can be quantified by histology and T1 mapping, and specific antihypertensive agents like losartan, ramipril, and perindopril may help attenuate it.
Answers are grounded in this paper and cite their sources.
Hypertension linked to higher myocardial collagen; supports fibrosis role in HTN but leaves open therapeutic implications.
BACKGROUND: Hypertension (HTN) is a major risk factor for myocardial fibrosis (MF), a key contributor to cardiac dysfunction. This meta-analysis aims to evaluate the relationship between HTN and MF using data from imaging and histological studies. METHODS: This study was searched EMBASE, PubMed, Cochrane Library, and Google Scholar to identify observational and interventional studies evaluating the association between HTN, blood pressure (BP), and antihypertensive medications with MF, assessed by histology or cardiac magnetic resonance imaging (T1 mapping parameters: extracellular volume fraction [ECV%] and native T1 values). RESULTS: A total of 39 studies comprising 45,776 participants were included in the analysis. The meta-analysis showed that HTN was significantly related to MF indicators, including collagen volume fraction (weighted mean difference [WMD]: 4.66; 95% confidence interval [CI]: 2.57 to 6.75), native T1 values (WMD: 38.34; 95% CI: 16.30 to 60.37), and ECV% (WMD: 1.89; 95% CI: 0.66 to 3.12). Higher MF levels correlated with left ventricular hypertrophy, heart failure, and elevated BP. Losartan, ramipril, and perindopril help control BP and attenuate MF, while amlodipine and hydrochlorothiazide do not statistically significantly alleviate MF. CONCLUSIONS: The extent of MF is closely associated with various factors, underscoring the importance of its identification in hypertensive patients. Histology and T1 mapping parameters are effective for quantifying MF. Due to the variable effects of antihypertensive medications on MF, the use of specific agents to mitigate MF in hypertensive patients is recommended.
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Jiang et al. (2026) conducted a meta-analysis in Hypertension (n=45,776). Hypertension was evaluated on Collagen volume fraction (WMD 4.66, 95% CI 2.57 to 6.75). Hypertension was significantly associated with increased myocardial fibrosis indicators, including collagen volume fraction (WMD 4.66; 95% CI 2.57 to 6.75).
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