Abstract
BackgroundStudies regarding the association between prehypertension and the structual changes of left heart are scanty. However, which type of the geometrical change of left heart is predominated one in prehypertension and hypertension is controversial. It is therefore important to investigate geometrical and functional changes of left heart in adults with prehypertension and hypertension because of their prognostic significance.MethodsThe study was based on a cross-sectional design, a total of 10547 participants were classified into normotension group, prehypertension group and hypertension group. We analyzed clinical characteristics, echocardiographic parameters and distribution of left ventricular (LV) geometrical patterns in different groups.ResultsParticipants with prehypertension had higher values of most of echocardiographic parameters than those with normotension. The prevalence of left ventricular hypertrophy(LVH) was statistically different among three groups (P <0.001), and the rates of LVH in the three groups were 5.9, 8.6, 28.4 % by indexation to height2.7 and 4.9, 5.3, 19.3 % by indexation to BSA, respectively. The prevalence rates of eccentric hypertrophy, concentric remodeling and concentric hypertrophy were 7.3 %, 5.3 % and 1.4 % in prehypertension group, and 17.8 %, 8.8 % and 10.6 % in hypertension group. Logistic regression analysis showed that systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean artery pressure (MAP) were all independent risk factors for left cardiac structural changes, and pulse pressure (PP) was independent risk factor for concentric and eccentric hypertrophy. Among four indices, DBP levels with OR values of 1.192, 1.759 and 1.278 were the strongest indicator for concentric remodeling, concentric hypertrophy and eccentric hypertrophy, respectively (P <0.001).ConclusionsThere exists LV geometrical change in adults with prehypertension and hypertension in rural Chinese population, and the eccentric hypertrophy was the highest proportion of geometric alterations. SBP, DBP, MAP and PP were all positively associated with left cardiac structural changes, and the association of DBP was the strongest.
Highlights
Studies regarding the association between prehypertension and the structual changes of left heart are scanty
Distribution of left ventricular (LV) geometrical pattern Classification of LV geometry showed that the eccentric hypertrophy was the highest proportion of geometric alterations in hypertension and prehypertension groups.in the present study population
The prevalence of Left ventricular hypertrophy (LVH) was statistically different among three groups and the rates of LVH were higher when Left ventricular mass (LVM) was indexed to height2.7 than to body surface area (BSA) in our study
Summary
Studies regarding the association between prehypertension and the structual changes of left heart are scanty. Which type of the geometrical change of left heart is predominated one in prehypertension and hypertension is controversial. It is important to investigate geometrical and functional changes of left heart in adults with prehypertension and hypertension because of their prognostic significance. The geometrical patterns vary from one patient to another, which is predominated type in hypertension and prehypertension is controversial. Some investigators had reported that hypertensive patients had higher prevalence of geometrical and functional changes in left heart [6,7,8], but data regarding the association between prehypertension and geometrical and functional changes of left heart are scanty, especially in rural adults from Northeast China, where hypertension is prevalent. We conducted this study to investigate geometrical and functional changes of left heart in adults with prehypertension and hypertension in Northeast rural Chinese population
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