Initial left-ventricular hypertrophy was associated with a higher rate of uncontrolled blood pressure at follow-up compared to patients without hypertrophy (56% vs 44%; P<0.0001).
Cohort (n=4,693)
Yes
Does initial left-ventricular mass predict the probability of uncontrolled blood pressure in treated hypertensive outpatients?
Initial left-ventricular mass is a significant independent predictor of uncontrolled blood pressure in treated hypertensive patients, suggesting it could help identify patients requiring more aggressive antihypertensive therapy.
Effect estimate: OR 1.05 per 5 g/m (95% CI 1.01-1.10)
Absolute Event Rate: 56% vs 44%
p-value: p=<0.0001
BACKGROUND: Left-ventricular hypertrophy (LVH) is a marker of organ damage in hypertension and helps stratifying cardiovascular risk. Initial left-ventricular mass (LVM) is also a predictor of progression to hypertension, independently of initial blood pressure (BP) and other confounders. OBJECTIVES: To evaluate whether baseline LVM can influence BP control in treated hypertension. METHODS: We evaluated risk of uncontrolled BP (>140 or 90 mmHg under at least two medications), in relation to initial LVM in 4693 hypertensive outpatients (mean age 53±11 years, 43% women, 5% diabetic), without prevalent cardiovascular disease, from the Campania Salute Network. RESULTS: Uncontrolled BP was found in 2240 patients (48%). Participants with initial LVH were more often men, older, diabetic, had higher initial BP, fasting glucose, uric acid and triglycerides, and lower heart rate (HR), high-density lipoprotein-cholesterol and glomerular filtration rate than those without LVH (all P0.1). Among medication classes, only angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were associated with lower risk of uncontrolled BP (OR=0.83, 95% CI 0.71-0.96; P=0.01), independently of covariates. CONCLUSION: In a population of treated hypertensive patients, initial LVM is a significant predictor of uncontrolled BP, independently of major risk factors and antihypertensive therapy.
Izzo et al. (Sat,) conducted a cohort in Arterial hypertension (n=4,693). Initial left-ventricular hypertrophy (LVH) / mass (LVM) vs. No initial LVH was evaluated on Uncontrolled blood pressure (>140 or 90 mmHg under at least two medications) (OR 1.05 per 5 g/m, 95% CI 1.01-1.10, p=<0.0001). Initial left-ventricular hypertrophy was associated with a higher rate of uncontrolled blood pressure at follow-up compared to patients without hypertrophy (56% vs 44%; P<0.0001).