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Prevalence and prognosis of left ventricular diastolic dysfunction in community hypertension patients

Dan Zhou1, Mengqi Yan1, Qi Cheng1

  • 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.

BMC Cardiovascular Disorders
|June 13, 2022
PubMed

Insights

Left ventricular diastolic dysfunction (LVDD) in hypertension patients significantly increases the risk of major adverse cardiac events (MACE). Early detection of LVDD is crucial for risk stratification and management in hypertensive individuals.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Left ventricular diastolic dysfunction (LVDD) is prevalent in hypertension and linked to cardiovascular risk.
  • The impact of LVDD, as defined by new guidelines, on major adverse cardiac events (MACE) in hypertensive patients without prior cardiovascular disease remains unclear.

Purpose of the Study:

  • To evaluate the prevalence of LVDD in a community-based hypertension cohort.
  • To assess the association between LVDD and the incidence of MACE in this population.

Main Methods:

  • A cohort of 283 asymptomatic, non-ischemic hypertensive patients with baseline echocardiograms (2012-2014) was studied.
  • Patients were followed for a mean of 5.4 years for MACE, including myocardial infarction, revascularization, heart failure, stroke, and all-cause mortality.
  • Cox proportional hazards models were employed to analyze the association between LVDD and MACE.

Main Results:

  • 12.3% of hypertensive patients (35/283) were diagnosed with LVDD at baseline; women had a higher prevalence (15.5% vs. 8% in men).
  • Patients with LVDD experienced a higher incidence of MACE (26.6%) compared to those with normal diastolic function (9.9%).
  • LVDD emerged as a significant predictor of MACE (HR: 2.5; 95% CI: 1.20-5.25), outperforming the E/e' ratio (HR: 1.13; 95% CI: 1.04-1.22).

Conclusions:

  • LVDD is a strong independent predictor of MACE in hypertensive patients.
  • Current echocardiographic guidelines for LVDD detection are valuable for identifying high-risk individuals within the hypertensive population.
  • Risk stratification using LVDD diagnosis can aid in managing cardiovascular risk in hypertension.

Keywords:
HypertensionLeft ventricular diastolic dysfunctionMajor adverse cardiac eventsPredictor

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