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Determinants of left ventricular diastolic dysfunction in hypertensive patients

R Nazário Leão1, P Marques da Silva2, R Marques Pocinho3

  • 1Unidade Funcional Medicina 2, Hospital São José, Centro Hospitalar Lisboa Central-EPE, Lisboa, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal.

Hipertension Y Riesgo Vascular
|February 6, 2018
PubMed

Insights

Long-lasting, uncontrolled hypertension and tobacco smoking are key determinants of left ventricular diastolic dysfunction (LVDD) in hypertensive patients. These factors, along with specific cardiac remodeling, significantly increase the risk of LVDD development.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Cardiovascular Disease

Background:

  • Hypertensive heart disease progresses to left ventricular diastolic dysfunction (LVDD).
  • LVDD is linked to increased cardiovascular morbidity and mortality.
  • Identifying LVDD determinants in hypertension is crucial for patient outcomes.

Purpose of the Study:

  • To explore the key determinants of left ventricular diastolic dysfunction (LVDD) in patients with hypertension.
  • To analyze risk factors contributing to LVDD progression in hypertensive individuals.
  • To understand the relationship between hypertension characteristics and LVDD.

Main Methods:

  • Secondary analysis of the Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study.
  • Utilized Mann-Whitney and Chi-square tests for univariable analysis.
  • Employed multiple logistic regression and ROC curve analysis to identify LVDD determinants and model discriminative capacity.

Main Results:

  • Older age, longer hypertension duration, uncontrolled hypertension, tobacco smoking, higher systolic blood pressure, and slower heart rate were associated with LVDD.
  • Multivariate analysis identified uncontrolled hypertension (AdjOR 36.90), smoking (AdjOR 6.66), and hypertension duration (AdjOR 1.03) as significant determinants.
  • Eccentric hypertrophy and concentric remodeling also showed associations with LVDD, with a model AUC of 0.95.

Conclusions:

  • Left ventricular diastolic dysfunction (LVDD) in hypertensive patients is strongly associated with long-standing, uncontrolled hypertension.
  • Tobacco smoking, concentric remodeling, and eccentric hypertrophy are significant contributing factors to LVDD.
  • These findings highlight critical targets for preventing LVDD in hypertension management.
Abstract

Keywords:
Determinantes de la disfunción diastólica del ventrículo izquierdoDiastolic dysfunction determinantsDisfunción diastólica del ventrículo izquierdoHipertensión arterialHypertensionLeft ventricular diastolic dysfunction

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