There is little information on left ventricular (LV) hypertrophy (LVH) development during antihypertensive treatment. We evaluate incident LVH in a treated hypertensive cohort, the Campania Salute Network registry. We analyzed prospectively 4290 hypertensives (aged 50.3±11.1 years, 40% women) with at least 1-year follow-up, without LVH at baseline. Incident LVH was defined as the first detection of echocardiographic LV mass index ≥47 in women or ≥50 g/m2.7 in men. During a median 48-month follow-up, 915 patients (21.3%) developed LVH. They were older, more frequently women, and obese (P<0.0001), with initial higher fasting glucose, diastolic and systolic blood pressure, LV mass index, lower heart rate and glomerular filtration rate, longer hypertension history and follow-up, and higher average systolic blood pressure during follow-up (all P<0.05), despite a more frequent treatment with Ca++-channel blockers and diuretics (both P<0.02). At multivariable Cox regression, incident LVH was independently associated with older age, female sex, obesity, higher average systolic blood pressure during follow-up, and initial greater LV mass index (all P<0.02). By categorizing patients according to obesity and sex, obesity independently increased the risk for incident LVH in both sexes (obese versus nonobese men: hazard ratio, 1.34; confidence interval, 1.05-1.72; P=0.019; and obese versus nonobese women: hazard ratio, 1.34; confidence interval, 1.08-1.66; P=0.007). Despite more aggressive antihypertensive therapy, 21% of hypertensive patients develop clear-cut LVH. After adjusting for confounders, risk of incident LVH is particular relevant among women and is further increased by the presence of obesity.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02211365.

Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients / Izzo, Raffaele; Losi, MARIA ANGELA; Stabile, Eugenio; Lönnebakken, Mai Tone; Canciello, Grazia; Esposito, Giovanni; Barbato, Emanuele; DE LUCA, Nicola; Trimarco, Bruno; DE SIMONE, Giovanni. - In: HYPERTENSION. - ISSN 0194-911X. - 69:1(2017), pp. 136-142. [10.1161/HYPERTENSIONAHA.116.08158]

Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients

IZZO, RAFFAELE;LOSI, MARIA ANGELA;STABILE, EUGENIO;CANCIELLO, GRAZIA;ESPOSITO, GIOVANNI;BARBATO, EMANUELE;DE LUCA, NICOLA;TRIMARCO, BRUNO;DE SIMONE, GIOVANNI
2017

Abstract

There is little information on left ventricular (LV) hypertrophy (LVH) development during antihypertensive treatment. We evaluate incident LVH in a treated hypertensive cohort, the Campania Salute Network registry. We analyzed prospectively 4290 hypertensives (aged 50.3±11.1 years, 40% women) with at least 1-year follow-up, without LVH at baseline. Incident LVH was defined as the first detection of echocardiographic LV mass index ≥47 in women or ≥50 g/m2.7 in men. During a median 48-month follow-up, 915 patients (21.3%) developed LVH. They were older, more frequently women, and obese (P<0.0001), with initial higher fasting glucose, diastolic and systolic blood pressure, LV mass index, lower heart rate and glomerular filtration rate, longer hypertension history and follow-up, and higher average systolic blood pressure during follow-up (all P<0.05), despite a more frequent treatment with Ca++-channel blockers and diuretics (both P<0.02). At multivariable Cox regression, incident LVH was independently associated with older age, female sex, obesity, higher average systolic blood pressure during follow-up, and initial greater LV mass index (all P<0.02). By categorizing patients according to obesity and sex, obesity independently increased the risk for incident LVH in both sexes (obese versus nonobese men: hazard ratio, 1.34; confidence interval, 1.05-1.72; P=0.019; and obese versus nonobese women: hazard ratio, 1.34; confidence interval, 1.08-1.66; P=0.007). Despite more aggressive antihypertensive therapy, 21% of hypertensive patients develop clear-cut LVH. After adjusting for confounders, risk of incident LVH is particular relevant among women and is further increased by the presence of obesity.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02211365.
2017
Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients / Izzo, Raffaele; Losi, MARIA ANGELA; Stabile, Eugenio; Lönnebakken, Mai Tone; Canciello, Grazia; Esposito, Giovanni; Barbato, Emanuele; DE LUCA, Nicola; Trimarco, Bruno; DE SIMONE, Giovanni. - In: HYPERTENSION. - ISSN 0194-911X. - 69:1(2017), pp. 136-142. [10.1161/HYPERTENSIONAHA.116.08158]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/658256
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