Dataset Information

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study.

ABSTRACT:

Background

Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women.

Methods

We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011-2013) and underwent two-dimensional echocardiography while free of prevalent coronary heart disease or heart failure. We categorized participants into 3 groups: optimal BP (BP <120 mm Hg and <80 mm Hg) (n = 402), prehypertension (n = 537), and hypertension (n = 3,932).

Results

Individuals with prehypertension (75±5 years) had higher left ventricular (LV) mass index and wall thickness, and higher prevalence of abnormal LV geometry than those with optimal BP (74±5 years), but lower than those with frank hypertension (76±5 years). In addition, participants with prehypertension had impairment of diastolic parameters (E/A, E' and E/E'), and had higher prevalence of mild and moderate-severe diastolic dysfunction compared to those with optimal BP, but no differences in systolic parameters. These differences in cardiac structure and function remained significant after adjusting for important clinical covariates.

Conclusion

In the ARIC cohort at visit 5, prehypertension was associated with increased LV remodeling and impaired diastolic function, but not systolic function, suggesting that even mildly elevated BP within the normal range is associated with cardiac end-organ damage.

SUBMITTER: Santos AB

PROVIDER: S-EPMC5014084 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study.

Santos Angela B S AB Gupta Deepak K DK Bello Natalie A NA Gori Mauro M Claggett Brian B Fuchs Flavio D FD Shah Amil M AM Coresh Josef J Sharrett A Richey AR Cheng Susan S Solomon Scott D SD

American journal of hypertension 20150907 5

<h4>Background</h4>Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women.<h4>Methods</h4>We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2 ...[more]

PMID: 26350299

Similar Datasets

Project description:BackgroundAldosterone production and mineralocorticoid receptor activation are implicated in myocardial fibrosis and cardiovascular events.MethodsCardiac structure and function were assessed in 4547 participants without prevalent heart failure (HF) in the ARIC study (Atherosclerosis Risk in Communities), with echocardiography, aldosterone, and plasma renin activity measurement (2011-2013). Subjects were characterized by plasma renin activity as suppressed (≤0.5 ng/mL per hour) or unsuppressed (>0.5 ng/mL per hour). Cross-sectional relationships with cardiac structure and function, and longitudinal relationships with outcomes (HF hospitalization; HF and all-cause death; HF, death, myocardial infarction, and stroke; and incident atrial fibrillation) were assessed. Models were adjusted for demographic and anthropometric characteristics and additively, for blood pressure and antihypertensives.ResultsEvidence of primary aldosteronism physiology was prevalent (11.6% with positive screen) and associated with echocardiographic parameters. Renin suppression was associated with greater left ventricular mass, left ventricular volumes, and left atrial volume index, and a lower E/A ratio (adjusted P<0.001 for all). Higher aldosterone was associated with greater left ventricular mass and lower global longitudinal strain and lateral E'. The highest tertile of aldosterone was associated with a hazard ratio of 1.37 (95% CI, 1.06-1.77; 5.5-year follow-up) for incident atrial fibrillation relative to the lowest. Renin suppression was associated with HF (hazard ratio, 1.34 [95% CI, 1.05-1.72]; 7.3-year follow-up), although these relationships did not remain statistically significant after additional adjustment for hypertension.ConclusionsRenin suppression and aldosterone excess, consistent with primary aldosteronism pathophysiology, were associated with cardiac structural and functional alterations and may represent an early target for mitigation of fibrosis with mineralocorticoid receptor antagonists.

Dataset Information

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study.

Background

Methods

Results

Conclusion

Publications

Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets