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Left ventricular concentric geometry during treatment adversely affects cardiovascular prognosis in hypertensive

Maria Lorenza Muiesan1, Massimo Salvetti, Cristina Monteduro

  • 1Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.

Hypertension (Dallas, Tex. : 1979)
|March 10, 2004
PubMed

Insights

Persistent left ventricular hypertrophy (LVH) and concentric geometry in hypertensive patients predict cardiovascular events. Maintaining normal LVH and geometry during treatment improves prognosis, highlighting the importance of monitoring these factors.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Left ventricular (LV) mass and geometry are established risk predictors for cardiovascular events in hypertension.
  • Regression of LV hypertrophy (LVH) holds prognostic significance, but the impact of LV geometry changes during antihypertensive treatment on prognosis is not well-defined.

Purpose of the Study:

  • To determine the relationship between changes in LV geometry during antihypertensive treatment and subsequent cardiovascular prognosis in hypertensive patients.

Main Methods:

  • Prospective study of 436 uncomplicated hypertensive subjects with baseline and follow-up echocardiograms.
  • Patients were treated by their family doctor and followed for cardiovascular events after the last echocardiogram.

Main Results:

  • Persistence of LVH from baseline to follow-up independently predicted cardiovascular events.
  • Concentric LV geometry was associated with significantly greater cardiovascular morbidity and mortality compared to eccentric geometry, both in patients with and without LVH at follow-up.
  • Cardiovascular event incidence increased with higher LV mass index tertiles at follow-up, with significantly greater risk in those with concentric geometry.

Conclusions:

  • Persistence or development of concentric LV geometry during antihypertensive treatment is a significant independent predictor of cardiovascular events in hypertensive patients, regardless of baseline or follow-up LVH status.
  • Monitoring LV geometry changes alongside LV mass is crucial for refining prognostic assessment in hypertensive individuals.

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