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Updated: Sep 19, 2025
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Profiles of echocardiographic features associated with blood pressure in patients with hypertension
Wenlang Zhao1, Mingdan Wang1, Pan Zhou1
1Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center for Cardiovascular Diseases, Ministry of Education, Beijing, 100029, China.
Insights
Specific echocardiographic features, including left atrial diameter and left ventricular mass index, are linked to blood pressure (BP) levels in hypertensive adults. These findings aid in early detection of target organ damage from elevated BP.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- The relationship between blood pressure (BP) levels and multidimensional echocardiographic features in hypertensive individuals requires further clarification.
- Understanding these associations is crucial for assessing cardiovascular risk and guiding treatment strategies.
Purpose of the Study:
- To identify specific echocardiographic characteristics associated with varying blood pressure levels in a cohort of adult hypertensive patients.
- To explore the correlation between systolic and diastolic BP and key echocardiographic parameters.
Main Methods:
- A cohort of 2,092 adult hypertensive participants who underwent echocardiography was analyzed.
- Multivariate regression analysis was employed to investigate the associations between BP levels and echocardiographic features.
Main Results:
- Increased systolic BP correlated with larger left atrial diameter, increased left ventricular (LV) mass index, and greater ascending aorta diameter.
- Elevated diastolic BP was associated with increased LV mass index, aortic root diameter, and ascending aorta diameter.
- The E/A ratio showed a decrement with both increased systolic and diastolic BP.
Conclusions:
- Specific echocardiographic features, including LV structure, ascending aorta diameter, and E/A ratio, are significantly associated with BP levels.
- Left atrial diameter and aortic root diameter showed specific associations with systolic and diastolic BP, respectively.
- These identified echocardiographic markers may serve as valuable indicators for the early detection of target organ damage in hypertension.
Abstract:
The multidimensional echocardiographic features associated with BP level are unclear. This study aimed to identify the multidimensional echocardiographic features associated with BP. In total, 2 092 adult participants (aged ≥18 years) with hypertension who underwent echocardiography in Beijing between July 2017 and January 2020 as part of the Multi-provincial Cohort for Hypertension study were enrolled. The associations between BP levels and echocardiographic features were investigated by multivariate regression analysis. After multivariable adjustment, a 1 SD (15.4 mmHg) increase in systolic BP was associated with a 0.21-mm increment (95% CI 0.06-0.35) in left atrial diameter, a 2.17-g/m2 increment (95% CI 1.46-2.88) in LV mass index, a 0.25-mm increment (95% CI 0.11-0.39) in ascending aorta diameter and a 0.03 decrement (95% CI -0.04, -0.01) in the E/A ratio. A 1 SD (10.1 mmHg) increase in diastolic BP was associated with a 1.51-g/m2 increment (95% CI 0.80-2.21) in LV mass index, a 0.46-mm increment (95% CI 0.31-0.61) in aortic root diameter, a 0.77-mm increment (95% CI 0.63-0.91) in ascending aorta diameter, and a 0.05 decrement (95% CI -0.07, -0.04) in E/A ratio. In conclusion, specific echocardiographic features were associated with the BP level. LV structure, ascending aorta diameter, and the E/A ratio were associated with systolic and diastolic BP. Left atrial diameter was positively associated only with systolic BP, and aortic root diameter was positively associated only with diastolic BP. These echocardiographic features may be valuable for early identification of target organ damage caused by elevated BP.
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