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Prevalence of left ventricular hypertrophy in elderly patients with well controlled hypertension
E Jones1, T O Morgan, P Califiore
1Hypertension Unit, Repatriation Hospital, Heidelberg, Victoria, Australia.
Insights
Even with well-controlled hypertension for years, many older adults develop left ventricular hypertrophy (LVH). This study highlights the need for potentially earlier or more aggressive blood pressure management to prevent cardiac changes.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Left ventricular hypertrophy (LVH) is a common cardiac adaptation to hypertension.
- Long-term hypertension management aims to prevent target organ damage, including cardiac remodeling.
- The prevalence of LVH in elderly hypertensive patients with seemingly controlled blood pressure requires further investigation.
Purpose of the Study:
- To assess the prevalence of left ventricular hypertrophy (LVH) in elderly hypertensive patients with well-controlled blood pressure.
- To investigate potential predictors of LVH in this patient cohort.
- To inform clinical guidelines regarding hypertension management in older adults.
Main Methods:
- Echocardiography was used to measure left ventricular dimensions in 154 hypertensive patients (aged ≥55 years).
- Patients had a history of well-controlled hypertension for at least 2 years.
- Analysis focused on 103 patients with satisfactory echocardiographic studies and no other cardiac lesions.
Main Results:
- A high prevalence of left ventricular hypertrophy (LVH) was observed, with 52% of patients exhibiting LVH.
- 48% of patients demonstrated normal left ventricular dimensions.
- Neither the degree of blood pressure control nor the specific antihypertensive medications used predicted the presence of LVH.
Conclusions:
- Well-controlled hypertension in older adults is associated with a significant prevalence of left ventricular hypertrophy (LVH).
- Current treatment strategies may be insufficient to prevent cardiac remodeling in this population.
- Earlier intervention, more intensive blood pressure reduction, or alternative pharmacological approaches should be considered to mitigate LVH risk.
Abstract:
1. Left ventricular hypertrophy (LVH) was measured by echocardiography in 154 patients, mostly males, aged 55 years or more, with hypertension who had been well controlled for at least 2 years. 2. Satisfactory studies with no other cardiac lesions were available for 103 patients; 52% had LVH and 48% had normal left ventricular dimensions. 3. In patients with well controlled hypertension there was a high prevalence of LVH despite adequate control for at least 2 years. Neither the level of control nor the drugs used appeared to predict the outcome. 4. Consideration needs to be given to earlier treatment, greater lowering of blood pressure, or different drugs to reduce this high prevalence of LVH.