P1685Risk factors and earliest signs of heart damage in young adults with hypertension

Abstract

Abstract Background It is well known that the risk of cardiovascular complications becomes higher even in high normal BP ranges. High normal BP is usually asymptomatic in young age. It is important to establish the main risk factors and the initial signs of cardiac dysfunction at early stages of arterial hypertension (AH) formation. Objective To assess the prevalence of leading risk factors and to investigate the global longitudinal strain rate of left ventricle (LV) by speckle tracking (STE) method in young men with high normal pressure. Methods The study involved 80 patients aged 22 (20; 25) years. The first group (I) included 55 subjects with high normal office BP values (130–139/85–89 mm Hg), the second group (II) consisted of 25 subjects with office BP less than 130/85 mm Hg. Anthropometric and blood biochemical parameters were tested in all subjects. The heart status was assessed according to transthoracic echocardiography-data. The test was performed on an expert class apparatus General Electric Vivid 7 in the B and M mode by the pulse wave and color flow Doppler. LV functional status was assessed by STE with GLPS analysis. STE data was obtained in B-mode from three apical positions with a frame rate of 80–90 per minute. longitudinal peak systolic strain (LPSS) in basal, midwall and apical segments as well as a LV walls was assessed in the compared groups. The parameters tested are presented as median, interquartile range, average and standard deviation. Results Both groups were comparable in age. Smoking (25.9% and 28.6%, p=0.54) and total cholesterol (48,1% and 45,5%; p=0,11) were highly prevalent in groups I and II. Overweight is registered significantly more frequently in subjects with high BP (41.5% and 14.3 respectively, p=0.0009). Family history of premature cardiovascular disease, heart rate, diabetes, uric acid were comparable in both groups. The GLPS value was significantly lower in the group with high normal BP than in the reference group: −19,1 (−17,71; −20,2) and −20,9 (−20,6; −22,4) (p=0,0014). The decrease of LPSS at the basal and midwall segments was recorded more often in subjects with high normal BP (p=0.0008 and p=0.0003, respectively). LPSS in all LV walls was significantly lower in group I. LPSS in anteroseptal wall was 18.7±3.4 and 21.1±4.1, p=0.029; in anterior wall it was 19.8±2.9 and 22.3±3.0, p=0.006; in lateral wall it was 18.7±3.3 and 20.9±1.9, p=0.004; in inferolateral wall it was 18.7±3.3 and 21.1±3.2, p=0.017), in inferior was (19.8±3,1 and 22.3±2.2, p=0,002), in inferoseptal was (17.2±3.4 and 19.8±1.6, p=0.0007) in groups I and II, respectively. The nature of revealed changes in the subjects with high blood pressure requires further targeted investigation. Conclusion The multisegment GLPS decrease may be the earliest marker of myocardial dysfunction in the initial stages of hypertension. The contribution of overweight is evident in the persistent BP increase.