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Published on: May 30, 2021
Arterial hypertension and morphologic abnormalities of cardiac chambers: results from the Copenhagen General
Andreas Fuchs1, J Tobias Kühl1, Per E Sigvardsen1
1Department of Cardiology, The Heart Center, Rigshospitalet.
Insights
Untreated or inadequately treated arterial hypertension is linked to increased cardiac chamber abnormalities. This highlights the connection between high blood pressure and organ damage.
Area of Science:
- Cardiology
- Radiology
- Public Health
Background:
- Arterial hypertension (AH) can cause cardiac chamber enlargement and remodeling, indicative of organ damage.
- Cardiac computed tomography (CT) is a key imaging tool for assessing cardiac chamber morphology.
- Understanding the prevalence of cardiac abnormalities across AH categories in the general population is crucial.
Purpose of the Study:
- To investigate the relationship between clinical categories of arterial hypertension and the prevalence of cardiac chamber abnormalities.
- To assess cardiac chamber abnormalities using cardiac CT in a large general population cohort.
Main Methods:
- A cohort of 4747 individuals (mean age 60, 46% male) from the Copenhagen General Population Study underwent 320-detector CT.
- Participants were categorized into: normotensive, untreated hypertensive, treated controlled hypertensive, and treated uncontrolled hypertensive groups.
- Cardiac chamber abnormalities assessed included left ventricular (LV) remodeling/hypertrophy, left atrial enlargement, and LV/right ventricular enlargement.
Main Results:
- Overall, 23% of individuals exhibited chamber abnormalities.
- Left ventricular concentric remodeling was the most common (10%), particularly in treated hypertensive individuals.
- Elevated blood pressure, with or without treatment, was associated with higher frequencies of chamber abnormalities (32-40%) compared to normotensive individuals (14-27%).
Conclusions:
- Untreated or inadequately treated AH is associated with the highest prevalence of cardiac chamber enlargement and remodeling.
- These findings underscore a significant link between elevated blood pressure and the development of hypertension-mediated organ damage.
- Cardiac CT is valuable for detecting these changes in a general population setting.
Objectives:
In patients with arterial hypertension (AH), hypertension-mediated organ damage may be manifested by cardiac chamber enlargement and/or remodeling. Cardiac computed tomography imaging has emerged as an important method for morphological assessment of cardiac chambers. We tested the hypothesis that prevalence of cardiac chamber abnormalities is specifically related to clinical categories of AH in the general population.
Methods:
We studied 4747 individuals, mean age was 60 years (range: 40-93), 46% were men, undergoing 320-detector computed tomography in the Copenhagen General Population Study. Clinical categories of AH were: normotensive (n = 2484), untreated hypertensive (n = 1301), treated controlled hypertensive (n = 412) and treated uncontrolled hypertensive (n = 550). Chamber abnormalities in the form of left ventricular (LV) concentric remodeling, LV eccentric hypertrophy, LV concentric hypertrophy or left atrial enlargement were assessed, in addition to LV or right ventricular enlargement.
Results:
Chamber abnormalities were present in 23% of all individuals. Combined LV and left atrial abnormalities were rare (<2%). LV concentric remodeling (10%) was the most prevalent abnormality, and most commonly found in individuals with treated hypertension. LV and right ventricular enlargements were unrelated to hypertension. The highest frequencies of chamber abnormalities were found in individuals of elevated blood pressure (BP) with (40%) or without (32%) treatment, as opposed to individuals of normal BP with (27%) or without (14%) treatment, P less than 0.0001.
Conclusion:
In a general population cohort, untreated or inadequately treated AH was associated with the highest prevalence of cardiac chamber enlargement and remodeling. These observations suggest a strong link between elevated BPs and development of hypertension-mediated organ damage.
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