Abstract 9610: Aortic Stiffness and Increased Left Ventricular Mass Predict Progress From Prehypertension to Hypertension

Abstract

Introduction: Whether aortic stiffness and increased left ventricular (LV) mass can predict progress from prehypertension to hypertension is not well investigated. Hypothesis: The aim of this study was to find predictors of hypertension and evaluate the clinical implications of aortic stiffness and increased LV mass in disease-free prehypertensive population. Methods: 510 prehypertensive subjects in the Korean Genome Epidemiology Study (KoGES) were observed for four years. In addition to clinical information, left ventricular mass index (LVMI), left atrial volume index (LAVI), aortic pulse wave velocity (PWV), carotid intima-media thickness (cIMT) and other cardiovascular characteristics were obtained at baseline. Baseline clinical and cardiovascular characteristics were compared between subjects that developed hypertension and did not, and independent predictors of hypertension were determined. Results: Out of 510 participants, 237 subjects developed hypertension during four years (46%). After multivariate adjustment, high range prehypertension (OR=4.27 [2.63-9.63], p=0.000), 5th quintile of LAVI (OR=3.38 [1.63-7.04], p=0.001), 5th quintile of LVMI (OR=2.982 [1.399-6.359], p=0.005), 4th (OR=2.881 [1.372-6.049], p=0.005) and 5th quintiles of PWV (OR=2.283 [1.067-4.885], p=0.033) predicted development of hypertension. Subjects in low range prehypertension at baseline and hypertension at the final visit (“fast increase in blood pressure (BP)”) had the highest baseline LVMI, while those with high range prehypertension at baseline and not-hypertension at the final visit ("slow increase in BP") had the lowest baseline LVMI (p=0.005 for fast BP increase vs. slow BP increase). Conclusions: In prehypertensive population, presence of aortic stiffness and increased LV mass independently predicted development of hypertension. Further, increased LVMI at baseline was correlated with fast increase in BP in the future. PWV and echocardiography should be performed to recognize subjects at high risk of hypertension, because they possibly benefit from pre-emptive medical treatment.