Differential Influences of Achieved Blood Pressure on Cardiovascular Outcomes by Left Ventricular Geometries According to Chinese Ethnicity‐Specific Echocardiographic Criteria for Hypertensive Patients

Abnormal LV geometrics implied higher cardiovascular risk for hypertensive patients. Ethnicity-specific cardiographic criteria classified more accurately the left ventricular (LV) geometric patterns for Chinese than international guideline. We hypothesized that the influences of achieved blood pressure on prognosis varied by different LV geometrics based on ethnicity-specific echocardiographic criteria. We enrolled participants from a nationwide public health research project in China and categorized into four groups including normal geometry (NG), concentric remoldeling (CR), eccentric remodeling (ER), and concentric hypertrophy (CH) based on LV geometrics. The cumulative cardiovascular risks across different LV geometric patterns and achieved SBP subgroups were analyzed using survival analysis and Cox regression. The LV geometric patterns based on ethniticy-specific diagnostic thresholds from the EMINICA study distinguished accurately the cardiovascular risks for Chinese hypertensive patients. Notably, a lower achieved SBP of below 130 mmHg conferred significantly additional benefits to subjects with CH (Multivariable HR = 0.342 for primary endpoint, 95%CI 0.162-0.719, p = 0.005). An achieved SBP below 130 mmHg elevates slightly but significantly the risk of coronary artery disease (CAD) in patients with concentric remodeling (Multivaribale HR = 2.351 for hospitalization of CAD, 95%CI 1.145-4.830, p = 0.010). The influence of achieved SBP on prognosis varied by different LV structural patterns based on ethnicity-specific diagnostic thresholds. The achieved SBP below 130mHg might bring additional benefits for patients with CH.