Abstract 19356: Sex-differences in Left Ventricular Mass Changes in Treated Hypertensive Outpatients: The Campania Salute Network

Abstract

Introduction: In clinical trials, women achieve less regression of hypertensive LV hypertrophy (LVH) than men. Whether this is evident also in less selective hypertensive patients is uncertain. Hypothesis: Find sex-differences in LV mass changes during hypertensive treatment. Methods: We evaluated 6969 hypertensive patients with follow-up>12 months (43% women, 53±11 years) from the Campania Salute Network Registry, during a 4-year median follow up. Clinical and echocardiographic data from baseline and last visit during follow-up were used. Results: At baseline, women were older, had higher systolic blood pressure (BP) and heart rate, lower diastolic BP, Framingham Risk Score and renal function, and included more patients with obesity and LVH (all p<0.001 vs. men). Despite optimal BP control in 62% of patients, LV mass increased over time in the total population, similarly in males and females, whereas relative wall thickness increased only in females (all p<0.0001). Percent change in LVM was positively related to follow-up duration and change in systolic BP, diastolic BP and body mass index (BMI) in both sexes (all p<0.0001). During follow-up, women, but not men, exhibited significant increase in BMI (both p<0.0001). After adjusting for age, follow-up duration, changes in BP and BMI, LV mass increased in the presence of both controlled and uncontrolled BP, but in men the change was less evident when BP was controlled (all p<0.001). In subgroups with baseline LVH (by sex-specific LVM normalized by height2.7), LV mass decreased over time in men, but increased in women (p<0.001). Conclusions: In hypertensive, Caucasian outpatients participating in the Campania Salute Network registry, lack of reduction in LV mass was particularly evident in women, independently of confounders including age, duration of follow-up, changes in BP and BMI, with negligible benefit of BP control on LVH.