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Patients with elevated blood pressure or stage 1 hypertension have structural heart disease

Reyan Ghany1, Ana Palacio2,3, Gordon Chen1

  • 1Department of Medicine, Chen Neighborhood Medical Centers.

Blood Pressure Monitoring
|May 15, 2020
PubMed

Insights

New hypertension guidelines may identify more patients with structural heart disease. Echocardiograms can help risk-stratify individuals with elevated blood pressure or stage 1 hypertension for targeted treatment.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Diagnostic Imaging

Background:

  • The 2017 ACC/AHA guidelines lowered the hypertension threshold to 130/80 mmHg.
  • Treatment is now recommended for high-risk patients based on new categories.

Purpose of the Study:

  • To assess the association between new blood pressure categories and left ventricular (LV) structural changes.
  • To determine if echocardiograms aid in risk stratification and treatment initiation for hypertension.

Main Methods:

  • A cross-sectional study involving 16,650 primary care patients who underwent screening echocardiograms.
  • Patients were categorized by blood pressure: normal, elevated, stage 1, or stage 2 hypertension.
  • Structural heart disease defined as LV hypertrophy and abnormal LV mass index; Framingham score used for risk assessment.

Main Results:

  • Elevated blood pressure (OR 1.30) and stage 1 hypertension (OR 1.69) were associated with structural heart disease.
  • Among 542 patients with stage 1 hypertension and low/intermediate Framingham score, 19% had structural heart disease.

Conclusions:

  • A significant proportion of patients with elevated blood pressure or stage 1 hypertension exhibit structural heart disease.
  • Screening echocardiograms may be valuable for risk stratification in patients not meeting traditional treatment criteria.
Abstract

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