Cesare Cuspidi1,2, Carla Sala3, Marijana Tadic4, Elisa Gherbesi3, Rita Facchetti1, Guido Grassi1,5, Giuseppe Mancia2. 1. Department of Medicine and Surgery, University of Milano-Bicocca. 2. Clinical Research Unit, Istituto Auxologico Italiano IRCCS. 3. Department of Clinical Sciences and Community Health, University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di Milano, Milan, Italy. 4. Department of Cardiology, Charité-University-Medicine Campus Virchow Klinikum, Berlin, Germany. 5. Istituto di Ricerche a Carattere Scientifico Multimedica, Sesto San Giovanni, Milan, Italy.
Abstract
AIM: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. DESIGN: Studies were identified by crossing the following search terms: 'prehypertension,' 'high normal blood pressure,' 'heart,' 'LV hypertrophy' (LVH), 'LV geometry,' 'LV mass,' and 'echocardiography.' RESULTS: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70-2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40-1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50-3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher (P < 0.001 for all) than in pre-HTN participants. CONCLUSION: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting.
AIM: The association between prehypertension (pre-HTN) and abnormal left ventricular (LV) geometric patterns is unclear. We performed a meta-analysis of echocardiographic studies aimed to provide a new piece of information on LV geometric alterations in untreated pre-HTN individuals. DESIGN: Studies were identified by crossing the following search terms: 'prehypertension,' 'high normal blood pressure,' 'heart,' 'LV hypertrophy' (LVH), 'LV geometry,' 'LV mass,' and 'echocardiography.' RESULTS: A total 60 949 participants (38 536 normotensive, 14 453 pre-HTN, and 7960 HTN individuals) were included in six studies. LV concentric remodelling was the most common abnormal pattern in pre-HTN participants followed by eccentric and concentric LVH. Compared with normotensive group, pre-HTN exhibited a higher risk of LV concentric remodelling (OR 1.89, CI 1.70-2.10, P < 0.001), eccentric LVH (OR 1.65, CI 1.40-1.90, P < 0.001) and concentric LVH (OR 2.09, CI 1.50-3.00, P < 0.001). The likelihood of having abnormal LV patterns in HTN was significantly higher (P < 0.001 for all) than in pre-HTN participants. CONCLUSION: Our meta-analysis shows that alterations in LV geometry in pre-HTN individuals are intermediate between normotensive and HTN individuals. These findings suggest that pre-HTN is associated to early changes in LV structure and geometry, and preventive strategies may have a protective impact on development of subclinical cardiac damage in this setting.