High-normal blood pressure and abnormal left ventricular geometric patterns: a meta-analysis. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Cuspidi, Cesare; Sala, Carla; Tadic, Marijana; Gherbesi, Elisa; Facchetti, Rita; Grassi, Guido; Mancia, Giuseppe
• Is Part Of: Journal of hypertension. Volume 37:Issue 7(2019:Jul.)
• Publication Date: 2019-07
• Subjects: echocardiography -- left ventricular geometric patterns -- meta-analysis -- prehypertension; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000002063
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Aim: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. Design: Studies were identified by crossing the following search terms: 'prehypertension, ' 'high normal blood pressure, ' 'heart, ' 'LV hypertrophy' (LVH), 'LV geometry, ' 'LV mass, ' and 'echocardiography.' Results: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70–2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40–1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50–3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher ( P < 0.001 for all) than in pre-HTN participants. Conclusion: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting. Abstract : Supplemental Digital Content is available in the text