Clinical Characteristics Associated With the Different Geometric Patterns of the Heart in Hypertension

Objective: To analyse the association of the different geometric patterns of the heart with systolic and diastolic blood pressure (BP) and their circadian patterns, as well as with heart rate in patients with hypertension.Design and method: The medical records of 501 hypertensive patients from 4 hypertension units who underwent echocardiography and 24-hour ambulatory blood pressure monitoring (ABPM) within 1 month were reviewed. Clinical and BP data were compared between patients with different cardiac geometric patterns, defined according to current guidelines. Results: Mean age: 63±13yr, 40.9% women, 24h-BP: 134.2±15.6/78.4±10.3 mmHg. Geometric heart patterns were normal (N; n=108, 22%), concentric hypertrophy (CH; n=193, 38%), eccentric hypertrophy (EH, n=91, 18%), and concentric remodelling (CR, n=109, 22%). Differences were found in SBP and heart rate (either 24 h, day and night), night-to-day SBP ratio, age, sex, body mass index (BMI), dyslipidaemia, renal parameters and duration of hypertension among geometric heart pattern groups. A multinomial logistic regression analysis was used with the variables showing differences between groups to estimate independent associations with each cardiac geometric pattern, with normal geometry as the reference group (day and night SBP and heart rate excluded to avoid collinearity). Older age, BMI, UAE and 24h-SBP were associated with CH, while age, BMI, and 24-h SBP were associated with the presence of EH. CR was associated with older age and heart rate (Table) Conclusions: Cardiac geometric patterns in hypertension are linked to distinct clinical profiles. In both concentric and eccentric hypertrophy, age, BMI, and SBP were the main associated factors. In contrast, CR showed a specific association with heart rate, in addition to age. Albuminuria was independently associated with CH.