S-29-4: ASSOCIATION BETWEEN OBESE STATUS AND INCIDENT LEFT VENTRICULAR HYPERTROPHY DIFFERED BY ACHIEVED SYSTOLIC BLOOD PRESSURE LEVEL

Abstract

Background: Obesity frequently coexists with hypertension, and both confer additive effects on left ventricular hypertrophy (LVH) development. Little is known whether a more intensive blood pressure (BP) control is needed to mitigate this risk. The primary aim of this study was to evaluate the association between obese status and incident LVH according to achieved systolic BP (SBP) level at follow-up in community hypertensive populations. Methods: Hypertensive patients without LVH at baseline (n = 1842; obesity was 19.7%) were included. The China and American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI) criteria were used to define LVH. The association between obese status and incident LVH according to achieved SBP level at follow-up (equal to or greater than 140, 130–139 and less than 130 mm Hg) was evaluated using Cox regression model. Results: After a median follow-up of 2.90 years, the incidence of LVH in the normal weight, overweight and obese groups were 17.0%, 25.0% and 31.1% (P < 0.001). Obesity was associated with incident LVH, with adjusted hazard ratio (HR) of 3.64 (95% CI 2.39–5.55). When achieved SBP equal to or greater than 140 mm Hg and at 130–139 mm Hg, this association remained significant; when achieved SBP less than130 mm Hg, this association was attenuated (adjusted HR 1.51 and 95% CI 0.89–2.56). When applying the ASE/EVCAI criteria, the results were consistent except for the differences in classification of LV geometry. Conclusion: A lower achieved SBP level may be needed to mitigate the additive effects of obesity and hypertension on LVH development. Randomized clinical trials are needed to corroborate these findings.