What is the clinical evidence from this study?

Study design: Cohort. Population: Healthy normotensive subjects (n=500). Intervention: Interventricular septum (IVS) thickness vs. Lower IVS thickness. Primary outcome: Systolic blood pressure above the median during follow-up (OR 1.99, 95% CI 1.31-3.02).

What does this research mean for the field?

In young healthy male aviators, an interventricular septum thickness above the median was associated with a twofold increased risk of developing a systolic blood pressure above the median over 7.5 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2008Open Access

Interventricular Septum Thickness Predicts Future Systolic Hypertension in Young Healthy Pilots

Key Result

In young healthy male aviators, an interventricular septum thickness above the median was associated with a twofold increased risk (OR 1.99) of developing a systolic blood pressure above the median over 7.5 years.

Study Design

Type

Cohort (n=500)

Multicenter

Structured PICO

Does increased baseline interventricular septum thickness predict the development of systolic hypertension in young healthy men?

Population

500 healthy male Israeli Air Force aviators, mean age 20.5±3.3 years (range 17-40), with baseline BP of 125±13/74±8 mmHg. Excluded if echocardiographs were inconclusive, had significant cardiac defects, or had less than 1 year of BP follow-up.

Intervention

Baseline echocardiographic evaluation of interventricular septum (IVS) thickness

Outcome

Systolic blood pressure levels and development of systolic hypertension during follow-upsurrogate

Increased baseline interventricular septum thickness in young healthy men predicts long-term elevation of systolic blood pressure, suggesting that structural heart changes may precede rather than merely result from hypertension.

Main Result

Effect estimate: OR 1.99 (95% CI 1.31-3.02)

Limitations

Only a single baseline blood pressure value based on two measurements was used.
24-hour ambulatory blood pressure monitoring was not performed, which may have overlooked masked hypertension.
Baseline blood pressure measurements may have been overestimated due to stress during the physical examination.
The study population consisted entirely of young males, limiting generalizability.

Abstract

Left ventricular hypertrophy (LVH) has been associated with hypertension, although debate exists as to whether LVH is caused by elevated blood pressure (BP) or is a risk factor for its development. The present study evaluates the association between left ventricular structure and the development of hypertension in a young healthy population. We followed young healthy Israeli Air Force aviators from initial echocardiography at the start of their military service to a mean of 7.5+/-3.0 years. Data collection included annual BP measurements, height, weight, smoking habits, and lipid profile. We monitored 500 Air Force men with a mean age of 20.5+/-3.3 (range, 17-40) years and baseline BP of 125+/-13/74+/-8 mmHg. Systolic BP during follow-up was associated with baseline systolic BP, interventricular septum (IVS) thickness, and ejection fraction, whereas diastolic BP was associated only with baseline diastolic BP and body mass index. The probability that the systolic BP during follow-up would be higher than the median was twice that in those with an IVS thickness greater than the median. In conclusion, IVS thickening was associated with long-term elevation of systolic BP. Therefore, it seems that IVS thickening is not merely a result of long-term BP elevation, but may predict the development of systolic hypertension.

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