Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects
Abstract Aims The impact of blood pressure (BP) levels on subclinical left ventricular (LV) dysfunction and possible sex‐specific difference remains unclarified. This study investigated the relationship between BP categories given in the new 2017 American College of Cardiology (ACC)/American Heart A...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13860 |
| _version_ | 1818205999349104640 |
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| author | Koki Nakanishi Masao Daimon Yuriko Yoshida Jumpei Ishiwata Naoko Sawada Megumi Hirokawa Hidehiro Kaneko Tomoko Nakao Yoshiko Mizuno Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro |
| author_facet | Koki Nakanishi Masao Daimon Yuriko Yoshida Jumpei Ishiwata Naoko Sawada Megumi Hirokawa Hidehiro Kaneko Tomoko Nakao Yoshiko Mizuno Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro |
| author_sort | Koki Nakanishi |
| collection | DOAJ |
| description | Abstract Aims The impact of blood pressure (BP) levels on subclinical left ventricular (LV) dysfunction and possible sex‐specific difference remains unclarified. This study investigated the relationship between BP categories given in the new 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and subclinical LV dysfunction in subjects free of cardiac disease. Methods and results We examined antihypertensive medication‐naive 858 individuals who underwent extensive cardiovascular health check‐up. LV global longitudinal (LVGLS) and circumferential strain (LVGCS) were assessed by two‐dimensional speckle‐tracking echocardiography. Participants were categorized into four groups: normal BP, elevated BP, isolated diastolic hypertension (IDH), and systolic hypertension (SH). Among the 858 participants, 422 individuals had normal BP, 113 had elevated BP, 160 had IDH, and 163 had SH. Prevalence of abnormal LVGLS (>−18.6%) was greatest in SH (19.0%), followed by IDH (17.5%), elevated BP (14.2%), and normal BP (7.1%, P < 0.001); no significant differences were observed for LVGCS (P = 0.671). In the multivariable analyses, IDH and SH were associated with impaired LVGLS [adjusted odds ratio (OR) 2.69 and 2.66, P < 0.001], and borderline significance was observed for elevated BP (adjusted OR 1.90, P = 0.060); there was no significant association between any of the BP groups and LVGCS. In sex‐stratified analysis, IDH and SH carried the significant risk of abnormal LVGLS in both sexes, while elevated BP was associated with LVGLS only in women. Conclusions Isolated diastolic hypertension and SH redefined by ACC/AHA guideline carried significant risk for LVGLS, but not LVGCS. Elevated BP was associated with LVGLS only in women. Our findings provide information on cardiac correlates of the newly established BP categories. |
| first_indexed | 2024-12-12T04:06:03Z |
| format | Article |
| id | doaj.art-5a44538481144b83a5cda9fe97e1336d |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-12T04:06:03Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-5a44538481144b83a5cda9fe97e1336d2022-12-22T00:38:47ZengWileyESC Heart Failure2055-58222022-06-01931766177410.1002/ehf2.13860Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjectsKoki Nakanishi0Masao Daimon1Yuriko Yoshida2Jumpei Ishiwata3Naoko Sawada4Megumi Hirokawa5Hidehiro Kaneko6Tomoko Nakao7Yoshiko Mizuno8Hiroyuki Morita9Marco R. Di Tullio10Shunichi Homma11Issei Komuro12Department of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanDepartment of Medicine Columbia University New York NY USADepartment of Medicine Columbia University New York NY USADepartment of Cardiovascular Medicine The University of Tokyo 7‐3‐1 Hongo, Bunkyo‐ku Tokyo 113‐8655 JapanAbstract Aims The impact of blood pressure (BP) levels on subclinical left ventricular (LV) dysfunction and possible sex‐specific difference remains unclarified. This study investigated the relationship between BP categories given in the new 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and subclinical LV dysfunction in subjects free of cardiac disease. Methods and results We examined antihypertensive medication‐naive 858 individuals who underwent extensive cardiovascular health check‐up. LV global longitudinal (LVGLS) and circumferential strain (LVGCS) were assessed by two‐dimensional speckle‐tracking echocardiography. Participants were categorized into four groups: normal BP, elevated BP, isolated diastolic hypertension (IDH), and systolic hypertension (SH). Among the 858 participants, 422 individuals had normal BP, 113 had elevated BP, 160 had IDH, and 163 had SH. Prevalence of abnormal LVGLS (>−18.6%) was greatest in SH (19.0%), followed by IDH (17.5%), elevated BP (14.2%), and normal BP (7.1%, P < 0.001); no significant differences were observed for LVGCS (P = 0.671). In the multivariable analyses, IDH and SH were associated with impaired LVGLS [adjusted odds ratio (OR) 2.69 and 2.66, P < 0.001], and borderline significance was observed for elevated BP (adjusted OR 1.90, P = 0.060); there was no significant association between any of the BP groups and LVGCS. In sex‐stratified analysis, IDH and SH carried the significant risk of abnormal LVGLS in both sexes, while elevated BP was associated with LVGLS only in women. Conclusions Isolated diastolic hypertension and SH redefined by ACC/AHA guideline carried significant risk for LVGLS, but not LVGCS. Elevated BP was associated with LVGLS only in women. Our findings provide information on cardiac correlates of the newly established BP categories.https://doi.org/10.1002/ehf2.13860Blood pressureLeft ventricular strainPrimary preventionSex differenceSpeckle‐tracking echocardiography |
| spellingShingle | Koki Nakanishi Masao Daimon Yuriko Yoshida Jumpei Ishiwata Naoko Sawada Megumi Hirokawa Hidehiro Kaneko Tomoko Nakao Yoshiko Mizuno Hiroyuki Morita Marco R. Di Tullio Shunichi Homma Issei Komuro Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects ESC Heart Failure Blood pressure Left ventricular strain Primary prevention Sex difference Speckle‐tracking echocardiography |
| title | Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects |
| title_full | Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects |
| title_fullStr | Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects |
| title_full_unstemmed | Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects |
| title_short | Blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication‐naive subjects |
| title_sort | blood pressure categorization and subclinical left ventricular dysfunction in antihypertensive medication naive subjects |
| topic | Blood pressure Left ventricular strain Primary prevention Sex difference Speckle‐tracking echocardiography |
| url | https://doi.org/10.1002/ehf2.13860 |
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