Prevalence of Left Ventricular Hypertrophy and Its Association with Blood Pressure Control in Hypertensive Patients at Vajira Hospital, Navamindradhiraj University LVH Prevalence and BP Control in Hypertensive Patients
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Abstract
OBJECTIVES: This study aimed to determine the prevalence of left ventricular hypertrophy (LVH) diagnosed via echocardiography and the relationship between blood pressure (BP) control and LVH and identify factors associated with LVH among patients with hypertension in Thailand.
METHODS: This cross-sectional study included 107 patients with hypertension who visited a cardiology clinic between March 2024 and August 2024. The baseline characteristics, office BP, and morning and evening home BP measurements of the participants were obtained. Echocardiographic criteria for LVH diagnosis are left ventricular mass index > 95 g/m2 in women and > 115 g/m2 in men. The primary outcomes were to determine the prevalence of LVH and assess the relationship between BP control and LVH.
RESULTS: The prevalence of LVH was 32.70%, with all the patients diagnosed with LVH exhibiting a concentric hypertrophy phenotype. Among the patients, 59.80% had controlled home BP, whereas 42% had controlled office BP. The prevalence of LVH was 22.50% among patients with both controlled office and home BP, 44.70% among those with both uncontrolled office and home BP, 20% in the group with controlled office but uncontrolled home BP, and 33.30% in the group with uncontrolled office BP but controlled home BP. Multivariate analysis showed that the number of antihypertensive drugs use was the only significant associated factor.
CONCLUSION: The prevalence of LVH is high among patients with hypertension, particularly those with uncontrolled office and home BP. This indicates the need for effective hypertension management strategies to prevent hypertension-mediated organ damage associated with LVH.
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References
Soubra L, Nureddin H, Omar AG, Saleh M. Factors associated with hypertension prevalence and control among lebanese type 2 diabetic patients. Int J Pharm Pharm Sci 2016;8(10):153-9.
Cushman WC, Evans GW, Byington RP, Goff DC Jr, Grimm RH Jr, Cutler JA, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010;362(17):1575-85.
Díez J, Frohlich ED. A translational approach to hypertensive heart disease. Hypertension 2010;55(1):1-8.
Artham SM, Lavie CJ, Milani RV, Patel DA, Verma A, Ventura HO. Clinical impact of left ventricular hypertrophy and implications for regression. Prog Cardiovasc Dis 2009;52(2):153-67.
McLenachan JM, Dargie HJ. Ventricular arrhythmias in hypertensive left ventricular hypertrophy. Relationship to coronary artery disease, left ventricular dysfunction, and myocardial fibrosis. Am J Hypertens 1990;3(10):735-40.
Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, et al. Cardiovascular morbidity and mortality in the Losartan intervention for endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359(9311):995-1003.
European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003;21(6):1011-53.
Sundström J, Lind L, Arnlöv J, Zethelius B, Andrén B, Lithell HO. Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men. Circulation 2001;103(19):2346-51.
Fagard RH, Celis H, Thijs L, Wouters S. Regression of left ventricular mass by antihypertensive treatment: a meta-analysis of randomized comparative studies. Hypertension 2009;54(5):1084-91.
Mathew J, Sleight P, Lonn E, Johnstone D, Pogue J, Yi Q, et al. Reduction of cardiovascular risk by regression of electrocardiographic markers of left ventricular hypertrophy by the angiotensin-converting enzyme inhibitor ramipril. Circulation 2001;104(14):1615-21.
Abergel E, Cohen A, Vaur L, Khellaf F, Menard J, Chatellier G. Accuracy and reproducibility of left ventricular mass measurement by subcostal M-mode echocardiography in hypertensive patients and professional bicyclists. Am J Cardiol 1993;72(7):620-4.
Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977;55(4):613-8.
Schillaci G, Verdecchia P, Porcellati C, Cuccurullo O, Cosco C, Perticone F. Continuous relation between left ventricular mass and cardiovascular risk in essential hypertension. Hypertension 2000;35(2):580-6.
Sundström J, Lind L, Nyström N, Zethelius B, Andrén B, Hales CN, et al. Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to the insulin resistance syndrome in elderly men. Circulation 2000;101(22):2595-600.
Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990;322(22):1561-6.
Behera A, Panda P, Mohapatra D, Behera S, Mohanty A. Prevalence and determinants of echocardiographic left ventricular hypertrophy among hypertensive patients in a tertiary care hospital. Asian J Pharm Clin Res 2018;11(4):56-60.
Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens 2012;26(6):343-9.
Conrady AO, Rudomanov OG, Zaharov DV, Krutikov AN, Vahrameeva NV, Yakovleva OI, et al. Prevalence and determinants of left ventricular hypertrophy and remodelling patterns in hypertensive patients: the St. Petersburg study. Blood Press 2004;13(2):101-9.
Chantra S, Bhuthong B. Echocardiographically detected left ventricular hypertrophy: prevalence and risk factors in Thai elderly men and women. J Med Assoc Thai 2000;83(9):1082-94.
de Simone G, Palmieri V, Bella JN, Celentano A, Hong Y, Oberman A, et al. Association of left ventricular hypertrophy with metabolic risk factors: the HyperGEN study. J Hypertens 2002;20(2):323-31.
Mancia G, Carugo S, Grassi G, Lanzarotti A, Schiavina R, Cesana G, et al. Prevalence of left ventricular hypertrophy in hypertensive patients without and with blood pressure control: data from the PAMELA population. Pressioni Arteriose Monitorate E Loro Associazioni. Hypertension 2002;39(3):744-9.
Antza C, Tziomalos G, Kostopoulos G, Trakatelli C, Kotsis V. The importance of out-of-office blood pressure measurement, as highlighted by the correlation with left ventricular hypertrophy in an untreated hypertensive population. Medicina (Kaunas) 2023;59(9):1636.
Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension. J Hypertens 2023;41(12):1874-2071.
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol 2018;71(19):e127-248.
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28(1):1-39.
Apitz A, Socrates T, Burkard T, Mayr M, Vischer AS. Prevalence and characterisation of severe left ventricular hypertrophy diagnosed by echocardiography in hypertensive patients. J Clin Med 2022;12(1):228.
Haider AW, Larson MG, Benjamin EJ, Levy D. Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. J Am Coll Cardiol 1998;32(5):1454-9.
Shipilova T, Pshenichnikov I, Kaik J, Volozh O, Abina J, Kalev M, et al. Echocardiographic assessment of the different left ventricular geometric patterns in middle-aged men and women in Tallinn. Blood Press 2003;12(5-6):284-90.
Wong RC, Yodwut C, Nitivudh K, Lerdverasirikul P, Boonyasirinant T, Laothavorn P, et al. Normal echocardiographic reference values of left ventricular structure and function in healthy Thai adults. Echocardiography 2008;25(8):805-11.
Cuspidi C, Facchetti R, Quarti-Trevano F, Dell’Oro R, Tadic M, Grassi G, et al. Left ventricular hypertrophy in isolated and dual masked hypertension. J Clin Hypertens (Greenwich) 2020;22(4):673-7.
