Key result
Central blood pressure and BMI were independent predictors of left ventricular remodeling among elderly women, with a 10 mmHg increase in central blood pressure raising the risk of left ventricular hypertrophy (HR 1.094).
Cohort (n=474)
No
Hazard Ratio: 1.094 (95% CI 1.011–1.202)
p-value: p=0.021
Central blood pressure and BMI are robust independent predictors of new-onset left ventricular remodeling (both hypertrophy and enlargement) in elderly Asian women.
Central BP and BMI were associated with new LV remodeling in elderly women; hypothesis-generating for risk stratification before practice change.
Left ventricular (LV) remodeling is closely linked to the progression of heart failure. There are limited data on the epidemiology of new onset LV remodeling among elderly women, which requires further investigation. We examined data from a community-based cohort of women aged > 65 years, who had received > 2 echocardiography scans from 2009 to 2014. Exclusion criteria for patients included prior echocardiographic evidence of left ventricular enlargement (LVE) or hypertrophy (LVH). LVE was defined as the index of left ventricular internal diameter at end-diastole to height, and LVH was defined as the left ventricular mass and thickness index which indicate hypertrophy. Of the 474 subjects (age 71.85 ± 6.47 years), 49 (10.3%) developed LVH, while 55 (11.6%) developed LVE during the mean follow-up period of 5 years. Independent predictors of LVH included: central blood pressure (CBP, per 10 mmHg) [HR 1.094, 95% CI 1.011–1.202], BMI˃25(kg/m 2 )[HR 1.306, 95% CI 1.175–1.434], B-type natriuretic peptide (BNP) ≥ 100 (pg/mL) [HR 1.635, 95% CI 1.107–3.311] and brachial-ankle pulse wave velocity (baPWV) ≥16 m/s [HR 1.605, 95% CI 1.474–2.039]. Predictors of LVE were CBP (per 10 mmHg) [HR 1.121, 95% CI 1.027–1.238], BMI˃25(kg/m 2 )[HR 1.302, 95% CI 1.173–1.444], Low-density lipoprotein cholesterol (LDL-C) [HR 1.193, 95%CI 1.013–1.405] and E/e’ ratio [HR 1.077, 95% CI 1.017–1.140]. CBP and BMI were demonstrated to be independent and robust predictors of left ventricular remodeling among elderly women, including both LVE and LVH. BNP and baPWV were specifically related to the development of LVH, whereas LDL-C and E/e’ ratio were related to LVE.
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Wu et al. (2017) conducted a cohort in Left ventricular remodeling (hypertrophy and enlargement) (n=474). Central blood pressure (per 10 mmHg increase) vs. Lower central blood pressure was evaluated on Development of left ventricular hypertrophy (LVH) (HR 1.094, 95% CI 1.011-1.202, p=0.021). Central blood pressure and BMI were independent predictors of left ventricular remodeling among elderly women, with a 10 mmHg increase in central blood pressure raising the risk of left ventricular hypertrophy (HR 1.094).
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