Key result
Concomitant hypertension in overweight adults without known cardiovascular disease was associated with abnormal LV geometry (OR 1.74; 95% CI 1.04-2.89; P=0.035) and lower systolic myocardial function.
Why the study?
The impact of concomitant hypertension on left ventricular systolic myocardial function and geometry in apparently healthy individuals with increased BMI needed evaluation.
Does concomitant hypertension worsen left ventricular geometry and systolic myocardial function in overweight participants without known cardiovascular disease?
Cross-Sectional (n=535)
Does concomitant hypertension worsen left ventricular geometry and systolic myocardial function in overweight participants without known cardiovascular disease?
In overweight individuals without known cardiovascular disease, concomitant hypertension is independently associated with subclinical left ventricular dysfunction and abnormal geometry.
Answers are grounded in this paper and cite their sources.
Hypertension was associated with subclinical LV changes in overweight adults without CVD; hypothesis-generating and requires prospective validation.
OBJECTIVE: We studied the impact of concomitant hypertension on left ventricular (LV) systolic myocardial function and geometry in apparently healthy women and men with increased BMI. MATERIAL AND METHODS: We performed a cross-sectional analysis of 535 participants (59% women) with BMI greater than 27 kg/m without known cardiovascular disease enrolled in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Hypertension was defined as use of antihypertensive treatment or elevated 24-h ambulatory blood pressure. Abnormal LV geometry was identified as increased relative wall thickness and/or LV mass index. Systolic myocardial function was assessed by midwall shortening (MWS) and speckle tracking peak global longitudinal strain (GLS). RESULTS: Hypertensive participants were older (49 vs. 46 years), had higher BMI and waist circumference, higher prevalences of diabetes and abnormal LV geometry (29 vs. 16%), and lower GLS (-19 vs. -20%) and MWS (16.3 vs. 17.1%) compared with normotensive participants (all P < 0.01). In multivariable linear regression analyses, hypertension was associated with lower GLS (β=0.11, P = 0.035) and lower MWS (β=0.09, P = 0.029) independent of sex, diabetes, LV hypertrophy, ejection fraction, and waist circumference. Hypertension was also associated with presence of abnormal LV geometry [odds ratio 1.74 (95% confidence interval 1.04-2.89), P = 0.035) independent of the same confounders. When replacing waist circumference with BMI in the models, hypertension retained its association with lower myocardial function, whereas the association with abnormal LV geometry was attenuated. CONCLUSION: In participants with increased BMI without known clinical cardiovascular disease, concomitant hypertension was associated with lower systolic myocardial function and more abnormal LV geometry. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov NCT02805478.
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Herfindal et al. (2020) conducted a cross-sectional in Increased BMI without known cardiovascular disease (n=535). Concomitant hypertension vs. Normotensive participants was evaluated on Abnormal LV geometry (OR 1.74, 95% CI 1.04-2.89, p=0.035). Concomitant hypertension in overweight adults without known cardiovascular disease was associated with abnormal LV geometry (OR 1.74; 95% CI 1.04-2.89; P=0.035) and lower systolic myocardial function.
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