High-normal blood pressure and abnormal left ventricular geometric patterns: a meta-analysis

Area of Science:

• Cardiology
• Cardiovascular Research
• Clinical Hypertension

Background:

• Prehypertension (pre-HTN) is a transitional stage between normotension and hypertension.
• The association between pre-HTN and left ventricular (LV) geometric patterns remains incompletely understood.
• Early detection of cardiac structural changes in pre-HTN is crucial for timely intervention.

Purpose of the Study:

• To conduct a meta-analysis of echocardiographic studies to investigate LV geometric alterations in untreated pre-HTN individuals.
• To clarify the relationship between pre-HTN and abnormal LV geometry.
• To provide insights into the early structural cardiac changes associated with pre-HTN.

Main Methods:

• A systematic literature search was performed using keywords related to prehypertension, blood pressure, heart, LV hypertrophy, LV geometry, LV mass, and echocardiography.
• A meta-analysis was conducted on data from six eligible echocardiographic studies.
• Participant data included normotensive, pre-HTN, and hypertensive individuals, totaling 60,949 participants.

Main Results:

• Left ventricular (LV) concentric remodeling was the most prevalent abnormal pattern in pre-HTN, followed by eccentric and concentric LVH.
• Compared to normotensive individuals, pre-HTN was associated with a significantly higher risk of LV concentric remodeling (OR 1.89), eccentric LVH (OR 1.65), and concentric LVH (OR 2.09).
• The risk of abnormal LV patterns was significantly higher in hypertensive individuals than in pre-HTN individuals.

Conclusions:

• Alterations in LV geometry in pre-HTN individuals represent an intermediate stage between normotensive and hypertensive states.
• Prehypertension is associated with early changes in LV structure and geometry.
• Preventive strategies targeting pre-HTN may offer protection against the development of subclinical cardiac damage.