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Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study.
Am J Hypertens. 2016 May; 29(5):568-74.AJ

Abstract

BACKGROUND

Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women.

METHODS

We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011-2013) and underwent two-dimensional echocardiography while free of prevalent coronary heart disease or heart failure. We categorized participants into 3 groups: optimal BP (BP <120 mm Hg and <80 mm Hg) (n = 402), prehypertension (n = 537), and hypertension (n = 3,932).

RESULTS

Individuals with prehypertension (75±5 years) had higher left ventricular (LV) mass index and wall thickness, and higher prevalence of abnormal LV geometry than those with optimal BP (74±5 years), but lower than those with frank hypertension (76±5 years). In addition, participants with prehypertension had impairment of diastolic parameters (E/A, E' and E/E'), and had higher prevalence of mild and moderate-severe diastolic dysfunction compared to those with optimal BP, but no differences in systolic parameters. These differences in cardiac structure and function remained significant after adjusting for important clinical covariates.

CONCLUSION

In the ARIC cohort at visit 5, prehypertension was associated with increased LV remodeling and impaired diastolic function, but not systolic function, suggesting that even mildly elevated BP within the normal range is associated with cardiac end-organ damage.

Authors+Show Affiliations

Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiology Division, Universidade Federal of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;Brigham and Women's Hospital, Boston, Massachusetts, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA;Brigham and Women's Hospital, Boston, Massachusetts, USA; Columbia University Medical Center, Brooklyn, New York, USA;Brigham and Women's Hospital, Boston, Massachusetts, USA; Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (MG);Brigham and Women's Hospital, Boston, Massachusetts, USA;Cardiology Division, Universidade Federal of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;Brigham and Women's Hospital, Boston, Massachusetts, USA;Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.Brigham and Women's Hospital, Boston, Massachusetts, USA;Brigham and Women's Hospital, Boston, Massachusetts, USA; ssolomon@rics.bwh.harvard.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26350299

Citation

Santos, Angela B S., et al. "Prehypertension Is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study." American Journal of Hypertension, vol. 29, no. 5, 2016, pp. 568-74.
Santos AB, Gupta DK, Bello NA, et al. Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study. Am J Hypertens. 2016;29(5):568-74.
Santos, A. B., Gupta, D. K., Bello, N. A., Gori, M., Claggett, B., Fuchs, F. D., Shah, A. M., Coresh, J., Sharrett, A. R., Cheng, S., & Solomon, S. D. (2016). Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study. American Journal of Hypertension, 29(5), 568-74. https://doi.org/10.1093/ajh/hpv156
Santos AB, et al. Prehypertension Is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study. Am J Hypertens. 2016;29(5):568-74. PubMed PMID: 26350299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study. AU - Santos,Angela B S, AU - Gupta,Deepak K, AU - Bello,Natalie A, AU - Gori,Mauro, AU - Claggett,Brian, AU - Fuchs,Flavio D, AU - Shah,Amil M, AU - Coresh,Josef, AU - Sharrett,A Richey, AU - Cheng,Susan, AU - Solomon,Scott D, Y1 - 2015/09/07/ PY - 2015/07/04/received PY - 2015/08/13/accepted PY - 2015/9/10/entrez PY - 2015/9/10/pubmed PY - 2017/1/18/medline KW - blood pressure KW - cardiovascular pathophysiology KW - echocardiography KW - prehypertension. SP - 568 EP - 74 JF - American journal of hypertension JO - Am J Hypertens VL - 29 IS - 5 N2 - BACKGROUND: Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women. METHODS: We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011-2013) and underwent two-dimensional echocardiography while free of prevalent coronary heart disease or heart failure. We categorized participants into 3 groups: optimal BP (BP <120 mm Hg and <80 mm Hg) (n = 402), prehypertension (n = 537), and hypertension (n = 3,932). RESULTS: Individuals with prehypertension (75±5 years) had higher left ventricular (LV) mass index and wall thickness, and higher prevalence of abnormal LV geometry than those with optimal BP (74±5 years), but lower than those with frank hypertension (76±5 years). In addition, participants with prehypertension had impairment of diastolic parameters (E/A, E' and E/E'), and had higher prevalence of mild and moderate-severe diastolic dysfunction compared to those with optimal BP, but no differences in systolic parameters. These differences in cardiac structure and function remained significant after adjusting for important clinical covariates. CONCLUSION: In the ARIC cohort at visit 5, prehypertension was associated with increased LV remodeling and impaired diastolic function, but not systolic function, suggesting that even mildly elevated BP within the normal range is associated with cardiac end-organ damage. SN - 1941-7225 UR - https://www.unboundmedicine.com/medline/citation/26350299/Prehypertension_is_Associated_With_Abnormalities_of_Cardiac_Structure_and_Function_in_the_Atherosclerosis_Risk_in_Communities_Study_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1093/ajh/hpv156 DB - PRIME DP - Unbound Medicine ER -