PS 17-32 VARIABLES ASSOCIATED TO LACK OF LEFT VENTRICULAR HYPERTROPHY REGRESSION IN TREATED HYPERTENSIVE PATIENTS

Abstract

Objective: Left ventricular hypertrophy (LVH) is an independent cardiovascular high risk predictor in hypertension (HBP) and its regression favorably affects the prognosis. The aim of this study is to determine the variables associated to lack of LVH regression in treated HBP patients (p). Design and method: Consecutive HBP p on at least 4 weeks stable treatment with LVH were included. Follow up for at least one year. Left ventricular mass index (LVMI) was measured by Devereux method at baseline and at follow up. LVH was considered > 95 g/m2 in women and > 115 g/m2 in men. Sixty demographic, anthropometric, cardiovascular risk factors, 2-D ultrasonographic, tissue Doppler, central aorta and peripheral hemodynamics, ABPM, laboratory and treatment variables were included in the algorithm. STATISTICAL ANALYSIS: Students t test, odds ratio, multivariate analysis; p < 0.05 considered statistically significant. Results: 188 treated HBP p included, follow up 588+-289 days. Sample mean age was 63.1+-13.8 years, 80 p (42.6%) were males. 144 p showed LVH regression (R) while 44 p (23.4%) persistent (P) LVH. Baseline LVMI was 113.2+-16.1 g/m2 in R LVH p and 118.5+-20.5 g/m2 in P LVH p (p=NS); follow up LVMI was 85.2+-17.6 g/m2 in R LVH p and 115.6+-14.1 g/m2 in P LVH p (p = 0.0005). 140 p (97.2%) decreased 1 SD and 48 p (33.3%) 2 SD LVMI in R LVH p while 4 p (9.1%) decreased 1 SD and 0 p (0%) 2 SD LVMI in P LVH p (p < 0.0005). Framingham score risk > 20% (OR 3.07; 95 % CI 1.55–6.06; p < 0.025), metabolic syndrome (OR 2.14; 95 % CI 1.08–4.25; p < 0.025); and high central aortic pressure (OR 2.80; 95 % CI 1.04–7.51; p < 0.005) were predictors of LVH P. Conclusions: 1) One over four treated HBP LVH p did not show regression; 2) High risk Framingham score, metabolic syndrome and central aortic pressure are LVH P predictors.