High-normal blood pressure and abnormal left ventricular geometric patterns: a meta-analysis

Cesare Cuspidi, Carla Sala, Marijana Tadic, Elisa Gherbesi, Rita Facchetti, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticle

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Abstract

AIM: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. DESIGN: Studies were identified by crossing the following search terms: 'prehypertension,' 'high normal blood pressure,' 'heart,' 'LV hypertrophy' (LVH), 'LV geometry,' 'LV mass,' and 'echocardiography.' RESULTS: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70-2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40-1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50-3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher (P < 0.001 for all) than in pre-HTN participants. CONCLUSION: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting.

Original languageEnglish
Pages (from-to)1312-1319
Number of pages8
JournalJournal of Hypertension
Volume37
Issue number7
DOIs
Publication statusPublished - Jul 1 2019

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Prehypertension
Meta-Analysis
Hypertension
Hypertrophy
Ventricular Remodeling
Left Ventricular Hypertrophy
Echocardiography

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

High-normal blood pressure and abnormal left ventricular geometric patterns : a meta-analysis. / Cuspidi, Cesare; Sala, Carla; Tadic, Marijana; Gherbesi, Elisa; Facchetti, Rita; Grassi, Guido; Mancia, Giuseppe.

In: Journal of Hypertension, Vol. 37, No. 7, 01.07.2019, p. 1312-1319.

Research output: Contribution to journalArticle

Cuspidi, Cesare ; Sala, Carla ; Tadic, Marijana ; Gherbesi, Elisa ; Facchetti, Rita ; Grassi, Guido ; Mancia, Giuseppe. / High-normal blood pressure and abnormal left ventricular geometric patterns : a meta-analysis. In: Journal of Hypertension. 2019 ; Vol. 37, No. 7. pp. 1312-1319.
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AU - Tadic, Marijana

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AU - Facchetti, Rita

AU - Grassi, Guido

AU - Mancia, Giuseppe

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N2 - AIM: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. DESIGN: Studies were identified by crossing the following search terms: 'prehypertension,' 'high normal blood pressure,' 'heart,' 'LV hypertrophy' (LVH), 'LV geometry,' 'LV mass,' and 'echocardiography.' RESULTS: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70-2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40-1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50-3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher (P < 0.001 for all) than in pre-HTN participants. CONCLUSION: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting.

AB - AIM: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. DESIGN: Studies were identified by crossing the following search terms: 'prehypertension,' 'high normal blood pressure,' 'heart,' 'LV hypertrophy' (LVH), 'LV geometry,' 'LV mass,' and 'echocardiography.' RESULTS: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70-2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40-1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50-3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher (P < 0.001 for all) than in pre-HTN participants. CONCLUSION: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting.

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