TY - JOUR
T1 - Prevalence and distribution of left ventricular diastolic dysfunction in treated patients with long-lasting hypertension
AU - Świerblewska, Ewa
AU - Wolf, Jacek
AU - Kunicka, Katarzyna
AU - Graff, Beata
AU - Polonis, Katarzyna
AU - Hoffmann, Michał
AU - Chrostowska, Marzena
AU - Szyndler, Anna
AU - Bandosz, Piotr
AU - Graff, Beata
AU - Narkiewicz, Krzysztof
N1 - Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/11/2
Y1 - 2018/11/2
N2 - Background: Although the presence of sub-clinical left ventricular diastolic dysfunction (LVDD) increases cardiovascular risk, the current ESH/ESC guidelines do not include the presence of this condition in the list of target organ damage or cardiovascular risk charts dedicated to the hypertensive population. Several conditions may predict the LVDD occurrence, however, clustering of these factors with hypertension makes the relationship less clear. Therefore, the aim of this study was to evaluate both the occurrence and the severity of diastolic dysfunction in a large cohort of treated hypertensives. Methods: We retrospectively analyzed records of 610 hypertensive participants of the CARE NORTH Study who consented to echocardiography and were free of overt cardiovascular disease. Mean age was 54.0 ± 13.9 years (mean ± SD), BMI 29.7 ± 4.8 kg/m2. The exclusion criteria were: established heart failure, LVEF <45%, coronary revascularization, valvular defect, atrial fibrillation, or stroke. The staging of LVDD was based on comprehensive transthoracic echocardiographic measurements. Results: 49.7% percent of the patients had normal diastolic function (38.8% vs. 59.0%, females (F) vs. males (M), respectively; p <.001). Grade 1 LVDD was documented in 24.4% (27.8% and 21.6%; F and M; p =.08) and grade 2 LVDD in 19.3% (24.9% and 14.6%; F and M; p =.001) of the patients. None were diagnosed with grade 3 LVDD. In the logistic regression model, female sex, advancing age, obesity status, established diabetes mellitus, higher 24-hour SBP, and increasing LVMI were identified as the independent variables increasing the odds for the presence of LVDD, whereas blood-lowering therapy attenuated the risk. Conclusions: There is an unexpectedly high prevalence of different forms of diastolic dysfunction in treated hypertensive patients who are free of overt cardiovascular disease.
AB - Background: Although the presence of sub-clinical left ventricular diastolic dysfunction (LVDD) increases cardiovascular risk, the current ESH/ESC guidelines do not include the presence of this condition in the list of target organ damage or cardiovascular risk charts dedicated to the hypertensive population. Several conditions may predict the LVDD occurrence, however, clustering of these factors with hypertension makes the relationship less clear. Therefore, the aim of this study was to evaluate both the occurrence and the severity of diastolic dysfunction in a large cohort of treated hypertensives. Methods: We retrospectively analyzed records of 610 hypertensive participants of the CARE NORTH Study who consented to echocardiography and were free of overt cardiovascular disease. Mean age was 54.0 ± 13.9 years (mean ± SD), BMI 29.7 ± 4.8 kg/m2. The exclusion criteria were: established heart failure, LVEF <45%, coronary revascularization, valvular defect, atrial fibrillation, or stroke. The staging of LVDD was based on comprehensive transthoracic echocardiographic measurements. Results: 49.7% percent of the patients had normal diastolic function (38.8% vs. 59.0%, females (F) vs. males (M), respectively; p <.001). Grade 1 LVDD was documented in 24.4% (27.8% and 21.6%; F and M; p =.08) and grade 2 LVDD in 19.3% (24.9% and 14.6%; F and M; p =.001) of the patients. None were diagnosed with grade 3 LVDD. In the logistic regression model, female sex, advancing age, obesity status, established diabetes mellitus, higher 24-hour SBP, and increasing LVMI were identified as the independent variables increasing the odds for the presence of LVDD, whereas blood-lowering therapy attenuated the risk. Conclusions: There is an unexpectedly high prevalence of different forms of diastolic dysfunction in treated hypertensive patients who are free of overt cardiovascular disease.
KW - blood pressure
KW - diastolic dysfunction
KW - echocardiography
KW - guidelines
KW - hypertension
UR - http://www.scopus.com/inward/record.url?scp=85052143619&partnerID=8YFLogxK
U2 - 10.1080/08037051.2018.1484661
DO - 10.1080/08037051.2018.1484661
M3 - Article
C2 - 30129379
AN - SCOPUS:85052143619
SN - 0803-7051
VL - 27
SP - 376
EP - 384
JO - Blood Pressure
JF - Blood Pressure
IS - 6
ER -