Left Ventricular Diastolic Dysfunction and Its Associated Factors among Middle-Aged Hypertensive Patients: A Hospital-Based Comparative Cross-Sectional Study

Background: Hypertension often progresses silently to left ventricular diastolic dysfunction before overt symptoms appear, and its early detection in middle-aged individuals is crucial to prevent heart failure with preserved ejection fraction. The purpose was to assess the prevalence of diastolic dysfunction and associated risk factors among middle-aged hypertensive patients and to compare the findings with age-matched normotensive controls. Methodology: This hospital-based comparative cross-sectional study enrolled 774 participants (387 hypertensive cases, 387 normotensive controls) aged 40-60 years. All underwent two-dimensional echocardiography with tissue Doppler imaging, and diastolic dysfunction was graded by the 2016 ASE/EACVI guidelines. Data were analysed in SPSS v25.0 using the chi-square test (p<0.05 significant). Results: Diastolic dysfunction was more prevalent among cases (Grade 1, 33.07%; Grade 2, 14.47%) than controls (18.09% and 7.49%). Within the hypertensive group, substance use (p=0.003), drug compliance (p<0.001) and antihypertensive drug class (p=0.005) differed significantly by dysfunction status, whereas age, sex and socioeconomic status did not; smoking alone was not significant (p=0.57). Dysfunction was paradoxically more frequent among drug-compliant patients (55.27% vs 28.57%) and Telmisartan users, consistent with confounding by indication. Conclusions: Diastolic dysfunction is common and frequently asymptomatic in middle-aged hypertensive adults, with Grade 1 predominating. Routine echocardiographic screening, stringent blood-pressure control and risk-factor modification are warranted to detect subclinical disease before symptomatic heart failure.