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Concomitant hypertension is associated with abnormal left ventricular geometry and lower systolic myocardial function

Bertina Herfindal¹, Eva Gerdts^1,2, Ester Anne Kringeland¹

¹Department of Clinical Science, University of Bergen.

Journal of Hypertension

|May 7, 2020

Insights

Hypertension in individuals with increased BMI is linked to reduced heart muscle function and abnormal heart structure. These findings highlight the cardiovascular risks associated with hypertension in this population.

Area of Science:

Cardiology
Cardiovascular Disease
Hypertension Research

Background:

Obesity and hypertension are significant risk factors for cardiovascular disease.
Left ventricular (LV) function and geometry can be affected by these conditions.
Understanding these impacts in seemingly healthy individuals is crucial for early detection and prevention.

Purpose of the Study:

To investigate the effect of hypertension on LV systolic myocardial function and geometry.
To assess these impacts in individuals with elevated Body Mass Index (BMI) but no known cardiovascular disease.
To explore the relationship between hypertension, BMI, and cardiac parameters.

Main Methods:

Cross-sectional analysis of 535 participants with BMI > 27 kg/m² from the FATCOR study.
Hypertension defined by treatment or 24-h ambulatory blood pressure.
LV geometry assessed by relative wall thickness and LV mass index.
Systolic function evaluated using midwall shortening (MWS) and global longitudinal strain (GLS).

Main Results:

Hypertensive participants had higher BMI, waist circumference, and prevalence of diabetes and abnormal LV geometry.
Hypertension was associated with lower GLS and MWS, independent of confounders.
Hypertension was also linked to abnormal LV geometry, with an odds ratio of 1.74.
Associations with myocardial function remained when BMI replaced waist circumference, but geometry associations attenuated.

Conclusions:

Concomitant hypertension is associated with impaired systolic myocardial function in individuals with increased BMI.
Hypertension also correlates with more abnormal LV geometry in this population.
These findings underscore the importance of managing hypertension to preserve cardiac health in individuals with elevated BMI.

Read full analysis

Abstract

Objective:

We studied the impact of concomitant hypertension on left ventricular (LV) systolic myocardial function and geometry in apparently healthy women and men with increased BMI.

Material And Methods:

We performed a cross-sectional analysis of 535 participants (59% women) with BMI greater than 27 kg/m without known cardiovascular disease enrolled in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Hypertension was defined as use of antihypertensive treatment or elevated 24-h ambulatory blood pressure. Abnormal LV geometry was identified as increased relative wall thickness and/or LV mass index. Systolic myocardial function was assessed by midwall shortening (MWS) and speckle tracking peak global longitudinal strain (GLS).

Results:

Hypertensive participants were older (49 vs. 46 years), had higher BMI and waist circumference, higher prevalences of diabetes and abnormal LV geometry (29 vs. 16%), and lower GLS (-19 vs. -20%) and MWS (16.3 vs. 17.1%) compared with normotensive participants (all P < 0.01). In multivariable linear regression analyses, hypertension was associated with lower GLS (β=0.11, P = 0.035) and lower MWS (β=0.09, P = 0.029) independent of sex, diabetes, LV hypertrophy, ejection fraction, and waist circumference. Hypertension was also associated with presence of abnormal LV geometry [odds ratio 1.74 (95% confidence interval 1.04-2.89), P = 0.035) independent of the same confounders. When replacing waist circumference with BMI in the models, hypertension retained its association with lower myocardial function, whereas the association with abnormal LV geometry was attenuated.

Conclusion:

In participants with increased BMI without known clinical cardiovascular disease, concomitant hypertension was associated with lower systolic myocardial function and more abnormal LV geometry.

Clinical Trial Registration:

URL: http://www.clinicaltrials.gov NCT02805478.

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