Echocardiography in Low‐Risk Hypertensive Patients
Background It is debated whether echocardiography should be part of the diagnostic workup in all hypertensive patients. We identified some factors potentially associated with left ventricular hypertrophy (LVH) at echocardiography in untreated hypertensive patients. Methods and Results We studied 215...
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013497 |
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| author | Costantino Mancusi Fabio Angeli Paolo Verdecchia Cristina Poltronieri Giovanni de Simone Gianpaolo Reboldi |
| author_facet | Costantino Mancusi Fabio Angeli Paolo Verdecchia Cristina Poltronieri Giovanni de Simone Gianpaolo Reboldi |
| author_sort | Costantino Mancusi |
| collection | DOAJ |
| description | Background It is debated whether echocardiography should be part of the diagnostic workup in all hypertensive patients. We identified some factors potentially associated with left ventricular hypertrophy (LVH) at echocardiography in untreated hypertensive patients. Methods and Results We studied 2150 patients without LVH at ECG. All patients underwent standard 12‐lead ECG and echocardiography. Mean age was 48.7 years, and mean office blood pressure was 154/97 mm Hg. Prevalence of echocardiographic LVH (LV mass >47.0 g/m2.7 in women and >50.0 g/m2.7 in men) was 37.1%. We developed a nomogram based on 7 items (age, smoking, body mass index, office systolic and diastolic blood pressure, Cornell voltage, and chronic kidney disease) on the basis of a multivariable logistic regression analysis. We internally validated the model by bootstrap recalibration and obtained a calibration curve to assess agreement in the validation data set. Probability of LVH at echocardiography ranged from <10% (score, ≤100 points) to >90% (score, ≥180 points). Proportion of patients with LVH progressively increased with the total score (χ2=444.8; P<0.001). Prevalence of LVH was <2% and 90% at the lower 5th and upper 95th percentile of its distribution, respectively. Conclusions We developed and validated a novel score to assess the probability of LVH at echocardiography in hypertensive patients without LVH at ECG. The score may guide the appropriateness of echocardiographic study in low‐risk hypertensive patients. Echocardiography appears most appropriate for score values >136 in men and >124 in women. |
| first_indexed | 2024-12-13T09:00:42Z |
| format | Article |
| id | doaj.art-936c760dac8047c583b88cd4df357c43 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:00:42Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-936c760dac8047c583b88cd4df357c432022-12-21T23:53:10ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-12-0182410.1161/JAHA.119.013497Echocardiography in Low‐Risk Hypertensive PatientsCostantino Mancusi0Fabio Angeli1Paolo Verdecchia2Cristina Poltronieri3Giovanni de Simone4Gianpaolo Reboldi5Hypertension Research Center and Department of Advanced Biomedical Sciences University Federico II of Naples Napoli ItalyDepartment of Medicine and Surgery University of Insubria Varese ItalyStruttura Complessa di Cardiologia Hospital of Perugia ItalyStruttura Complessa di Cardiologia Hospital of Perugia ItalyHypertension Research Center and Department of Advanced Biomedical Sciences University Federico II of Naples Napoli ItalyDepartment of Medicine University of Perugia ItalyBackground It is debated whether echocardiography should be part of the diagnostic workup in all hypertensive patients. We identified some factors potentially associated with left ventricular hypertrophy (LVH) at echocardiography in untreated hypertensive patients. Methods and Results We studied 2150 patients without LVH at ECG. All patients underwent standard 12‐lead ECG and echocardiography. Mean age was 48.7 years, and mean office blood pressure was 154/97 mm Hg. Prevalence of echocardiographic LVH (LV mass >47.0 g/m2.7 in women and >50.0 g/m2.7 in men) was 37.1%. We developed a nomogram based on 7 items (age, smoking, body mass index, office systolic and diastolic blood pressure, Cornell voltage, and chronic kidney disease) on the basis of a multivariable logistic regression analysis. We internally validated the model by bootstrap recalibration and obtained a calibration curve to assess agreement in the validation data set. Probability of LVH at echocardiography ranged from <10% (score, ≤100 points) to >90% (score, ≥180 points). Proportion of patients with LVH progressively increased with the total score (χ2=444.8; P<0.001). Prevalence of LVH was <2% and 90% at the lower 5th and upper 95th percentile of its distribution, respectively. Conclusions We developed and validated a novel score to assess the probability of LVH at echocardiography in hypertensive patients without LVH at ECG. The score may guide the appropriateness of echocardiographic study in low‐risk hypertensive patients. Echocardiography appears most appropriate for score values >136 in men and >124 in women.https://www.ahajournals.org/doi/10.1161/JAHA.119.013497blood pressurebody mass indexcardiovascular imagingguidelineleft ventricular hypertrophy |
| spellingShingle | Costantino Mancusi Fabio Angeli Paolo Verdecchia Cristina Poltronieri Giovanni de Simone Gianpaolo Reboldi Echocardiography in Low‐Risk Hypertensive Patients Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease blood pressure body mass index cardiovascular imaging guideline left ventricular hypertrophy |
| title | Echocardiography in Low‐Risk Hypertensive Patients |
| title_full | Echocardiography in Low‐Risk Hypertensive Patients |
| title_fullStr | Echocardiography in Low‐Risk Hypertensive Patients |
| title_full_unstemmed | Echocardiography in Low‐Risk Hypertensive Patients |
| title_short | Echocardiography in Low‐Risk Hypertensive Patients |
| title_sort | echocardiography in low risk hypertensive patients |
| topic | blood pressure body mass index cardiovascular imaging guideline left ventricular hypertrophy |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013497 |
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