Cesare Cuspidi1, Carla Sala2, Marijana Tadic3, Elisa Gherbesi2, Guido Grassi4, Giuseppe Mancia5. 1. Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy; Istituto Auxologico Italiano, Milano, Italy. Electronic address: cesare.cuspidi@unimib.it. 2. Department of Clinical Sciences and Community Health, University of Milano, Italy; Fondazione Ospedale Maggiore Policlinico di Milano, Italy. 3. Department of Cardiology, Charité-University-Medicine Campus Virchow Klinikum, Berlin, Germany. 4. Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy; Istituto di Ricerche a Carattere Scientifico Multimedica, Sesto San Giovanni, Milan, Italy. 5. Istituto Auxologico Italiano, Milano, Italy.
Abstract
AIM: The association between pre-hypertension (pre-HTN) and subclinical cardiac damage remains undefined. We performed a systematic meta-analysis of echocardiographic studies in order to provide a comprehensive information on structural and functional cardiac changes in untreated pre-HTN subjects. DESIGN: Studies were identified by crossing the following search terms: "pre-hypertension", "high normal blood pressure" "heart" "left ventricular hypertrophy", "left ventricular function", "diastolic function", "left atrial size", "aortic root size", "echocardiography." RESULTS: A total 73,556 subjects (44,170 normotensive, 17,314 pre-HTN, and 12,072 HTN individuals) of both genders were included in 20 studies. Left ventricular (LV) mass index and relative wall thickness (RWT) were greater in pre-HTN than in normotensives (standard means difference: 0.32 ± 0.07 and 0.30 ± 0.07, respectively, p < 0.001 for both). The E/e' ratio (0.26 ± 0.02, p < 0.001) and left atrium (LA) diameter were higher (0.55 ± 0.02, p < 0.001) in pre-HTN than in normotensive subjects. HTN subjects showed a greater LV mass index (0.27 ± 0.03, p < 0.001), RWT (0.23 ± 0.02, p < 0.001), increased E/e' ratio (0.38 ± 0.09, p < 0.001) as well as LA diameter (0.31 ± 0.12, p < 0.001) than pre-HTN subjects. CONCLUSIONS: Our meta-analysis suggests that alterations in cardiac structure and function in pre-HTN subjects are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN may not be a benign entity. If so, early preventive strategies may prevent preclinical cardiac damage.
AIM: The association between pre-hypertension (pre-HTN) and subclinical cardiac damage remains undefined. We performed a systematic meta-analysis of echocardiographic studies in order to provide a comprehensive information on structural and functional cardiac changes in untreated pre-HTN subjects. DESIGN: Studies were identified by crossing the following search terms: "pre-hypertension", "high normal blood pressure" "heart" "left ventricular hypertrophy", "left ventricular function", "diastolic function", "left atrial size", "aortic root size", "echocardiography." RESULTS: A total 73,556 subjects (44,170 normotensive, 17,314 pre-HTN, and 12,072 HTN individuals) of both genders were included in 20 studies. Left ventricular (LV) mass index and relative wall thickness (RWT) were greater in pre-HTN than in normotensives (standard means difference: 0.32 ± 0.07 and 0.30 ± 0.07, respectively, p < 0.001 for both). The E/e' ratio (0.26 ± 0.02, p < 0.001) and left atrium (LA) diameter were higher (0.55 ± 0.02, p < 0.001) in pre-HTN than in normotensive subjects. HTN subjects showed a greater LV mass index (0.27 ± 0.03, p < 0.001), RWT (0.23 ± 0.02, p < 0.001), increased E/e' ratio (0.38 ± 0.09, p < 0.001) as well as LA diameter (0.31 ± 0.12, p < 0.001) than pre-HTN subjects. CONCLUSIONS: Our meta-analysis suggests that alterations in cardiac structure and function in pre-HTN subjects are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN may not be a benign entity. If so, early preventive strategies may prevent preclinical cardiac damage.
Authors: Jinkee Park; Yongseong Na; Yunjung Jang; Song-Young Park; Hyuntae Park Journal: Int J Environ Res Public Health Date: 2020-10-21 Impact factor: 3.390
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