Left ventricular and carotid structure in untreated, uncomplicated essential hypertension: Results from the Assessment Prognostic Risk Observational Survey (APROS)

C. Cuspidi, G. Mancia, E. Ambrosioni, A. Pessina, B. Trimarco, A. Zanchetti, N. Acquarone, G. Lotti, G. Benemio, G. B. Ambrosio, M. Boscaro, G. Calcagnini, R. Manconi, P. Pola, M. Volpe, M. Campanini, C. Cappelletti, A. Cavatorta, L. Chiandussi, A. CircoG. D'Addetta, R. De Cesaris, E. Degli Esposti, C. De Matteis, A. Ferrari, R. Giovannetti, E. Grasso, V. Russo, A. Lechi, G. Leonetti, G. Maiorano, E. Marchesi, P. Margaroli, C. Martines, R. Mezzetti, L. Mos, R. Nami, G. Pascal, C. Pasotti, M. Penzo, G. Pinna, R. Ragazzoni, A. Rappelli, A. Santucci, A. Scala, A. Stella, M. Stornello, A. Venco

Research output: Contribution to journalArticlepeer-review

Abstract

The impact of hypertension on left ventricular (LV) and vascular structure and the relation of left ventricular hypertrophy (LVH) with vascular changes in untreated essential hypertensives has not been fully explored. This study investigated the prevalence of structural abnormalities of LV and carotid arteries and their determinants in a large population of untreated, uncomplicated essential hypertensive patients. The Assessment of Prognostic Risk Observational Survey was a multicentre (44 centres) prospective study including 1142 untreated hypertensives classified as low or medium cardiovascular risk on the basis of the routine diagnostic work-up recommended by the 1999 World Health Organization/International Society of Hypertension guidelines. All patients underwent ultrasound examinations of the heart and carotid arteries. LVH and carotid structural changes were diagnosed when: (1) LV mass index exceeded 125 g/m2 in men and 110g/m2 in women; (2) there was at least one plaque (focal thickening> 1.3 mm) in any segment of either carotid artery or a diffuse common carotid intima-media thickness (IMT) (average of IMT≥0.8 mm) was present. Overall, 1074 patients (504 women, mean age 48.1 ± 11.4 years) completed the study with ultrasonographic examinations of good technical quality. The prevalences of LVH and LV concentric remodelling in the total population were 26.8 and 10.7%, respectively. Eccentric hypertrophy was more prevalent than concentric hypertrophy (15.2 vs 11.6%). One or more carotid plaques or thickening were present in 27.4% of the patients. A stepwise increase in IM thickness occurred from the lowest values in patients with normal cardiac mass and geometry (0.68 mm to intermediate in those with LV remodelling (0.76 mm) and eccentric LVH (0.81 mm) and to the highest level in patients with concentric LVH (0.87 mm). Patients with LV concentric remodelling and concentric LVH had a significantly greater relative carotid wall thickness than those with normal geometry and eccentric LVH (0.25 and 0.26 vs 0.18 and 0.19, respectively, P

Original languageEnglish
Pages (from-to)891-896
Number of pages6
JournalJournal of Human Hypertension
Volume18
Issue number12
DOIs
Publication statusPublished - Dec 2004

Keywords

  • Carotid structure
  • Hypertension
  • Left ventricular hypertrophy
  • Ultrasonography

ASJC Scopus subject areas

  • Internal Medicine

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