STUDY OBJECTIVE: We examine the point prevalence of subclinical hypertensive heart disease in a cohort of urban emergency department (ED) patients with elevated blood pressure. METHODS: A convenience sample of hypertensive (blood pressure ≥ 140/90 mm Hg on 2 measurements) patients aged 35 years or older with no history of cardiac or renal disease who presented to a single urban ED and were asymptomatic from a cardiovascular perspective (ie, no symptoms of dyspnea or chest pain) were enrolled. All patients underwent a standardized evaluation (including echocardiography), and subclinical hypertensive heart disease was defined by the presence of one or more of the following criterion-based echocardiographic [corrected] findings: left-ventricular hypertrophy, systolic dysfunction, or diastolic dysfunction. RESULTS: A total of 161 patients were included. Mean age was 49.8 years (SD 8.3 years), 93.8% were black, and 51.6% were men. Nearly all (93.8%) had a history of hypertension, and many (68.3%) were receiving antihypertensive therapy at baseline. Mean systolic and diastolic blood pressures were 183.9 mm Hg (SD 25.1 mm Hg) and 109.5 mm Hg (SD 14.4 mm Hg), respectively. Subclinical hypertensive heart disease was found in 146 patients (90.7%; 95% confidence interval [CI] 85.2% to 94.3%), with most (n=131) displaying evidence of diastolic dysfunction (89.7%; 95% CI 83.7% to 93.7%). Left-ventricular hypertrophy was also common (n=89; 61.0%; 95% CI 52.9% to 68.5%) and was often (but not exclusively) present in those with diastolic filling abnormalities (n=75; 57.3%; 95% CI 48.7% to 65.4%). CONCLUSION: In our largely black cohort of ED patients with elevated blood pressure, subclinical hypertensive heart disease was highly prevalent, suggesting the need for coordinated efforts to reduce cardiac consequences of hypertension in such inner-city communities.
STUDY OBJECTIVE: We examine the point prevalence of subclinical hypertensiveheart disease in a cohort of urban emergency department (ED) patients with elevated blood pressure. METHODS: A convenience sample of hypertensive (blood pressure ≥ 140/90 mm Hg on 2 measurements) patients aged 35 years or older with no history of cardiac or renal disease who presented to a single urban ED and were asymptomatic from a cardiovascular perspective (ie, no symptoms of dyspnea or chest pain) were enrolled. All patients underwent a standardized evaluation (including echocardiography), and subclinical hypertensiveheart disease was defined by the presence of one or more of the following criterion-based echocardiographic [corrected] findings: left-ventricular hypertrophy, systolic dysfunction, or diastolic dysfunction. RESULTS: A total of 161 patients were included. Mean age was 49.8 years (SD 8.3 years), 93.8% were black, and 51.6% were men. Nearly all (93.8%) had a history of hypertension, and many (68.3%) were receiving antihypertensive therapy at baseline. Mean systolic and diastolic blood pressures were 183.9 mm Hg (SD 25.1 mm Hg) and 109.5 mm Hg (SD 14.4 mm Hg), respectively. Subclinical hypertensiveheart disease was found in 146 patients (90.7%; 95% confidence interval [CI] 85.2% to 94.3%), with most (n=131) displaying evidence of diastolic dysfunction (89.7%; 95% CI 83.7% to 93.7%). Left-ventricular hypertrophy was also common (n=89; 61.0%; 95% CI 52.9% to 68.5%) and was often (but not exclusively) present in those with diastolic filling abnormalities (n=75; 57.3%; 95% CI 48.7% to 65.4%). CONCLUSION: In our largely black cohort of ED patients with elevated blood pressure, subclinical hypertensiveheart disease was highly prevalent, suggesting the need for coordinated efforts to reduce cardiac consequences of hypertension in such inner-city communities.
Authors: Phillip D Levy; Robina Josiah Willock; Michael Burla; Aaron Brody; James Mahn; Alexander Marinica; Samar A Nasser; John M Flack Journal: J Am Soc Hypertens Date: 2016-10-28
Authors: Michael J Twiner; Alexander L Marinica; Kenneth Kuper; Allen Goodman; James J Mahn; Michael J Burla; Aaron M Brody; Justin A Carroll; Robina Josiah Willock; John M Flack; Samar A Nasser; Phillip D Levy Journal: Acad Emerg Med Date: 2017-01-30 Impact factor: 3.451
Authors: Phillip D Levy; Michael J Burla; Michael J Twiner; Alexander L Marinica; James J Mahn; Brian Reed; Aaron Brody; Robert Ehrman; Allie Brodsky; Yiying Zhang; Samar A Nasser; John M Flack Journal: Am J Hypertens Date: 2020-09-10 Impact factor: 2.689
Authors: James F Meschia; Cheryl Bushnell; Bernadette Boden-Albala; Lynne T Braun; Dawn M Bravata; Seemant Chaturvedi; Mark A Creager; Robert H Eckel; Mitchell S V Elkind; Myriam Fornage; Larry B Goldstein; Steven M Greenberg; Susanna E Horvath; Costantino Iadecola; Edward C Jauch; Wesley S Moore; John A Wilson Journal: Stroke Date: 2014-10-28 Impact factor: 7.914
Authors: Heather M Prendergast; Joseph Colla; Neal Patel; Marina Del Rios; Jared Marcucci; Ryan Scholz; Patience Ngwang; Katherine Cappitelli; Martha Daviglus; Samuel Dudley Journal: J Emerg Med Date: 2015-03-20 Impact factor: 1.484