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Left ventricular mass as a predictor of development of hypertension
R B Devereux1, G de Simone, M J Koren
1Department of Medicine, New York Hospital-Cornell Medical Center, NY 10021.
Insights
Left ventricular (LV) mass is a key indicator in hypertension. Higher baseline LV mass in normotensive adults predicts the future development of hypertension, highlighting its role in cardiovascular risk.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Biomarkers
Background:
- Left ventricular (LV) mass is central to hypertension and predicts cardiac complications.
- Increased LV mass may precede the clinical onset of hypertension.
- Previous studies show higher LV mass in offspring of hypertensive parents.
Purpose of the Study:
- To investigate if baseline LV mass predicts the development of hypertension in initially normotensive adults.
- To identify early predictors of hypertension beyond traditional risk factors.
Main Methods:
- A 5-year longitudinal study of 132 initially normotensive employed adults.
- Echocardiographic measurement of LV mass at baseline.
- Monitoring for the development of borderline hypertension during follow-up.
Main Results:
- 11% of participants developed borderline hypertension over 5 years.
- Baseline LV mass was the only significant predictor of developing hypertension (P < .005).
- Higher LV mass quartiles showed a progressively increased likelihood of developing hypertension.
Conclusions:
- Baseline LV mass is a strong predictor of future hypertension in normotensive adults.
- LV mass measurement may aid in identifying individuals at high risk for hypertension.
- This finding supports LV mass as an early indicator of cardiovascular risk.
Abstract:
The mass of left ventricular (LV) muscle plays a central role in hypertension. Echocardiographic LV mass has been shown to reflect the level of blood pressure over time, obesity, diet, and other factors, and to serve as the strongest predictor yet discovered, other than advancing age, of cardiac complications of hypertension. Recent research suggests, in addition, that individuals destined to become hypertensive have increased LV mass before hypertension becomes clinically apparent. Several published studies have compared LV mass in groups of normotensive children to young adults considered to be at high or low genetic risk of hypertension based on the presence or absence of hypertension in their parents. In each instance LV mass was higher in the offspring of hypertensive parents and this difference exceeded that expected for small differences in body habitus or arterial pressure. A longitudinal study in children also showed that LV mass predicted subsequent blood pressure level. We recently performed a study of 132 initially normotensive employed adults, 15 (11%) of whom developed borderline hypertension during a 5-year follow-up. The development of hypertension was not predicted by subject age, body habitus, blood pressure, or a variety of biochemical measurements. The only baseline measurement that predicted development of hypertension was that of LV mass (92 +/- 25 v 77 +/- 19 g/m2, P less than .005), and the likelihood of developing hypertension increased progressively from 3% in the lowest quartile of LV mass of 24% in the highest quartile.(ABSTRACT TRUNCATED AT 250 WORDS)