Under pressure: tackling hypertension as a pillar of preventive cardiology

This issue of the European Journal of Preventive Cardiology focuses on hypertension. In ‘Cumulative blood pressure exposure and global and regional cardiac structure and function: the MESA study’, Masrouri et al. from Iran and the United States examined the impact of long-term cumulative blood pressure (BP) on cardiac structure and function using cardiac magnetic resonance imaging (CMR).1 Analysing data from over 3000 adults in the Multi-Ethnic Study of Atherosclerosis (MESA), the study found that higher cumulative systolic BP was associated with increased left ventricular mass, impaired myocardial strain, and a greater risk of myocardial scarring (Figure 1). These associations remained significant after adjusting for age, sex, and systolic BP measured at the time of CMR. Importantly, similar results were observed in non-hypertensive individuals, particularly for left ventricular mass and myocardial strain, though not for myocardial scarring. The findings underscore the importance of monitoring cumulative BP exposure over time rather than relying solely on single-point measurements to improve cardiovascular risk assessment.