Prevalence of Doppler-Derived Left Ventricular Diastolic Dysfunction Among Newly Diagnosed Hypertensive Patients
I G Abubakar1, F Buba1,2, A I Oyati3,4
1Department of Medicine, Cardiology Unit, University of Maiduguri Teaching Hospital, Nigeria.
Insights
Left ventricular diastolic dysfunction (LVDD) is common in newly diagnosed hypertension patients, particularly in women. Early detection and management of LVDD are crucial for preventing heart disease progression.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Left ventricular diastolic dysfunction (LVDD) is an early indicator of hypertensive heart disease (HHD), often linked to left ventricular hypertrophy (LVH) and impaired relaxation.
- Untreated LVDD can advance to diastolic and systolic heart failure, with a higher prevalence in Nigerian hypertensive populations compared to Western countries.
- Early LVDD evaluation and blood pressure control are vital, as systemic hypertension may be asymptomatic initially.
Purpose of the Study:
- To determine the prevalence and stages of left ventricular diastolic dysfunction (LVDD) in newly diagnosed hypertensive patients.
- To assess LVDD in patients at the University of Maiduguri Teaching Hospital (UMTH).
Main Methods:
- A hospital-based, cross-sectional, observational study was conducted.
- 352 treatment-naïve hypertensive adult patients (≥18 years) from UMTH Cardiology Clinic (June 2019-June 2021) were included.
- Diagnostic criteria for LVDD and LVH were based on American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines.
Main Results:
- LVDD was prevalent in 58.5% of 352 newly diagnosed hypertensive patients (mean age 50.9±11.8 years, 54.3% female).
- Stage 1 LVDD (42.6%) was most common, followed by stage 2 (15.9%).
- LVDD prevalence was higher in females, older patients, and those with higher BMI, blood pressure, LAVI, and LVMI.
Conclusions:
- Left ventricular diastolic dysfunction (LVDD) is highly prevalent in newly diagnosed hypertensive patients, with stage 1 being most common.
- Significant predictors of LVDD include female gender, older age, higher BMI, elevated blood pressure, and increased LAVI and LVMI.
- Early detection and management of LVDD are essential for preventing adverse cardiovascular outcomes in hypertensive individuals.
Background:
The initial sign of hypertensive heart disease (HHD) is left ventricular diastolic dysfunction (LVDD), which is caused by remodeling of the left ventricle and left atrium, resulting in impaired relaxation of the left ventricle. LVDD is also partly due to left ventricular hypertrophy (LVH). If left untreated, LVDD can progress to diastolic heart failure and systolic heart failure. In Western countries, the prevalence of LVDD in long-term hypertensive patients ranges from 40.3% to 60%, but it is more common among hypertensive Nigerians. Since systemic hypertension can be asymptomatic in the early stages, it is important to evaluate LVDD early and control blood pressure to slow down its progression.
Aims And Objectives:
The study aims to highlight the prevalence of LVDD and to determine the stages of LVDD among newly diagnosed hypertensive patients at the University of Maiduguri Teaching Hospital (UMTH).
Method:
The study design is a hospital-based, cross-sectional, observational study. The study population consists of 352 consecutive treatment Naïve hypertensive adult patients aged 18 years and above who presented to the Cardiology Clinic of UMTH from June 2019 to June 2021. The study used the diagnostic criteria for LVDD and LVH which were based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Results:
A total of 352 newly diagnosed hypertensive patients were recruited, with a mean age of 50.9 ± 11.8 years, and 54.3% were female. The majority of patients (63.6%) were overweight or obese, with a mean body mass index (BMI) of 28.5 ± 4.6 kg/m2. The mean systolic blood pressure (SBP) was 155.7 ± 16.9 mmHg, and the mean diastolic blood pressure (DBP) was 92.8 ± 10.8 mmHg. LVDD was found in 58.5% of the patients, with stage 1 LVDD being the most common (42.6%), followed by stage 2 LVDD (15.9%). The prevalence of LVDD was significantly higher in females compared to males. Patients with LVDD were significantly older and had higher BMI, higher systolic and DBP, higher pulse pressure, higher LAVI, and higher LVMI compared to those without LVDD (P < 0.05).
Conclusion:
LVDD is highly prevalent among newly diagnosed hypertensive patients, with stage 1 being the most common. Female gender, older age, higher BMI, higher blood pressure, higher LAVI, and higher LVMI were significant predictors of LVDD. Early detection and appropriate management of LVDD may help to prevent adverse cardiovascular outcomes in hypertensive patients.
More Related Videos
04:48Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
07:13Author Spotlight: Advancing Neonatal Cardiac Diagnostics with Echocardiography-Derived Blood Speckle Imaging
Published on: December 22, 2023
Related Concept Videos
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:23Assessment of blood pressure in brachial artery(two-step method)
01:30Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:17Measurement of Blood Pressure
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...