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Pre-hypertension and subclinical cardiac damage: A meta-analysis of echocardiographic studies

Cesare Cuspidi1, Carla Sala2, Marijana Tadic3

  • 1Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy; Istituto Auxologico Italiano, Milano, Italy.

International Journal of Cardiology
|June 18, 2018
PubMed

Insights

Pre-hypertension (pre-HTN) is associated with intermediate cardiac changes between normal blood pressure and hypertension. These findings indicate pre-HTN is not benign and may benefit from early preventive strategies to avoid preclinical cardiac damage.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • The cardiac implications of pre-hypertension (pre-HTN) are not well-defined.
  • Subclinical cardiac damage in untreated pre-HTN requires further investigation.

Purpose of the Study:

  • To systematically analyze echocardiographic studies on pre-HTN.
  • To comprehensively assess structural and functional cardiac changes in pre-HTN.

Main Methods:

  • Systematic meta-analysis of 20 echocardiographic studies.
  • Inclusion of 73,556 subjects (normotensive, pre-HTN, and hypertensive).
  • Analysis of left ventricular mass, relative wall thickness, E/e' ratio, and left atrial size.

Main Results:

  • Pre-HTN subjects showed increased left ventricular mass index and relative wall thickness compared to normotensives.
  • Elevated E/e' ratio and left atrial diameter were observed in pre-HTN versus normotensive individuals.
  • Hypertensive subjects exhibited more pronounced cardiac alterations than pre-HTN subjects.

Conclusions:

  • Cardiac structural and functional alterations in pre-HTN are intermediate between normotensive and hypertensive states.
  • Pre-hypertension may not be a benign condition.
  • Early preventive strategies could mitigate preclinical cardiac damage in pre-HTN.
Abstract

Keywords:
EchocardiographyMeta-analysisPre-hypertensionSub-clinical cardiac damage

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