Poor blood pressure control and longer hypertension duration were associated with frequent cardiac target organ damage, including abnormal left ventricular geometry (~33%) and LA enlargement (>40%).
Cross-Sectional (n=234)
Yes
In treated hypertensive patients, cardiac target organ damage is common and associated with suboptimal blood pressure control and longer disease duration, highlighting the value of echocardiography in risk stratification.
Objective: To evaluate the prevalence and determinants of hypertension mediated target organ damage in the heart, as assessed by transthoracic echocardiography in treated hypertensive patients, and to determine its association with blood pressure control, disease duration, and treatment intensity. Design and method: This multicenter, observational, cross-sectional registry included adult hypertensive patients referred for transthoracic echocardiography between 2018 and 2019. Patients with cardiomyopathies, significant valvular heart disease, arrhythmias, reduced left ventricular systolic function, ischemic heart disease, or conditions affecting the thoracic aorta were excluded. Clinical variables included demographic characteristics, cardiovascular risk factors, hypertension duration, number of antihypertensive medications, and blood pressure control status. Echocardiographic evaluation comprised left ventricular dimensions, relative wall thickness, left ventricular mass indexed to body surface area and height, ventricular geometry, left atrial volume indexed to body surface area and height, aortic root and ascending aorta diameters, and diastolic function parameters. Measurements and cutoff values were defined according to current international echocardiographic recommendations. Results: The study included 234 patients with a mean age of 65 years; 56% were women. Although almost all patients were receiving antihypertensive therapy, adequate blood pressure control was achieved in less than half of the cohort. Left ventricular systolic function was preserved in all patients. Abnormal left ventricular geometry was observed in approximately one third of the population, predominantly concentric remodeling. Left atrial enlargement was prevalent, affecting more than 40% of patients, with no sex-related differences. Longer hypertension duration was associated with greater indexed left atrial volume, larger ascending aorta diameter, and impaired diastolic function parameters. Poor blood pressure control was associated with increased left ventricular wall thickness, higher left ventricular mass indices, abnormal ventricular geometry, left atrial enlargement, ascending aorta dilatation, and higher estimated filling pressures. Conclusions: In treated hypertensive patients, cardiac target organ damage is common and associated with suboptimal blood pressure control and longer disease duration. Echocardiographic markers of structural and functional remodeling identify high-risk phenotypes beyond blood pressure values alone and should play a central role in cardiovascular risk stratification and therapeutic decision-making.
Zaffora et al. (2026) conducted a cross-sectional in Hypertension (n=234). Poor blood pressure control and longer hypertension duration vs. Adequate blood pressure control and shorter hypertension duration was evaluated on Prevalence and determinants of hypertension mediated target organ damage in the heart. Poor blood pressure control and longer hypertension duration were associated with frequent cardiac target organ damage, including abnormal left ventricular geometry (~33%) and LA enlargement (>40%).