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Organ damage in treated middle-aged hypertensives compared to normotensives: results from a cross-sectional study in
1a Kävlinge Health Centre, 244 31 Kävlinge, Sweden.
Insights
Treated hypertension is linked to significant organ damage, including heart, brain, and retinal changes. These findings highlight the importance of managing blood pressure to prevent long-term health complications.
Area of Science:
- Cardiology
- Neurology
- Ophthalmology
Background:
- High blood pressure (hypertension) is a major risk factor for organ damage.
- Medical and imaging advancements have improved hypertension treatment and visualization of organ damage.
- This study investigates organ-specific changes in treated hypertensive individuals.
Purpose of the Study:
- To compare heart, brain, and retina in middle-aged treated hypertensives versus normotensives.
- To assess the impact of hypertension on cardiac structure and function.
- To evaluate neurological and retinal changes associated with hypertension.
Main Methods:
- 40 treated hypertensives and 40 normotensives were studied.
- Echocardiography assessed cardiac structure and function.
- Retinal photography and brain MRI evaluated vascular and neurological changes.
Main Results:
- Hypertensives showed increased left ventricular mass and left atrial size compared to normotensives.
- Diastolic dysfunction was more prevalent in hypertensives.
- Retinal arteriolar narrowing and brain white matter changes were significantly higher in hypertensives.
Conclusions:
- Treated hypertensives exhibit significant cardiac, retinal, and brain abnormalities compared to normotensives.
- These findings suggest that hypertension, even when treated, can lead to detectable organ damage.
- Further research is needed to determine if earlier or more intensive treatment could mitigate these changes.
Background:
High blood pressure contributes to organ damage. However, during the past two decades there have been great advances in the medical treatment of hypertension. Technical progress has also made it easier to visualize organ damage. Hence we found it of interest to examine heart, brain and retina in a group of middle-aged treated hypertensives, comparing the results with those from a group of middle-aged normotensives.
Methods:
The subjects were 40 (20 men) treated hypertensives and 40 (20 men) normotensives, who had previously taken part in a study in which ambulatory blood pressure monitoring had been performed. The heart was examined by echocardiography, the retina by photography and the brain by magnetic resonance imaging.
Results:
Office blood pressure and 24-h systolic/diastolic blood pressure (S/D) were 141/86 (13/7) mmHg and 128/81 (11/6) mmHg in the hypertensives and 125/78 -(10/8) mmHg and 118/74 (8/5) mmHg in the normotensives, respectively. Left ventricular mass was 101 (27) g/m2 in the hypertensives and 85 (18) g/m2 in the normotensives (p = 0.0025). The corresponding figures for the left atrium were 21.1 (3.1) mm/m2 in the hypertensives and 19.5 (2.2) mm/m2 in the normotensives (p < 0.001). E/A wave quotient was 1.09 (0.26) in the hypertensives and 1.26 (0.26) in the normotensives (p = 0.0045), while left ventricular systolic function did not differ between the groups. Ten hypertensives and one normotensive subject had left ventricular mass above normal range. Narrow retinal arteries were found in 22 hypertensives and 8 normotensives (p < 0.001). Brain magnetic resonance changes (deep white matter and/or periventricular) were found in 19 hypertensives and 9 normotensives (p = 0.0431).
Conclusions:
The hypertensives differed significantly from the normotensives concerning left ventricular mass, left atrium, left ventricular diastolic function and retinal vessel changes. Deep white matter and periventricular changes in the brain were also significantly different in the two groups. We can only speculate as to whether earlier antihypertensive treatment or further blood pressure reduction could have affected these differences.
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