Carolina Bertoluci et al. Murilo Foppa Angela Barreto Santiago Santos Sandra C. Fuchs Flávio Danni Fuchs
Abstract
Background
Prehypertension and stage I hypertension are associated with left ventricular (LV) remodeling. In this study, we compared echocardiographic parameters of preclinical hypertensive target organ damage in individuals with prehypertension and stage I hypertension selected from the same population.
Methods
We compared baseline echocardiogram measurements of participants included in the PREVER study with prehypertension (PREVER-prevention; n=106) or stage I hypertension (PREVER-treatment; n=128). Sex-specific differences in echocardiographic parameters were also investigated.
Results
Mean systolic and diastolic BP were significantly higher in the stage I hypertension group (141.0/90.4 mmHg) than in the prehypertension group (129.3/81.5 mmHg, P<0,001 for both). Mean age was 55 years old (30 to 70), with an almost equal number of men and women, of which 80% were white and 7% had diabetes. Most parameters of LV mass, LA size and diastolic function were similar between the prehypertension and stage I hypertension groups. Hypertensive individuals had larger LA diameter and posterior wall thickness, and lower lateral e’ velocities, even after adjustment for age, sex and body mass index. Sex-specific analysis showed higher LV mass in stage I hypertension compared to prehypertension only in women (141.1 ± 34.1 g vs. 126.1 ± 29.1 g, P<0.05).
Conclusions
In middle-aged individuals with low cardiovascular risk, differences in echocardiographic parameters related to target organ damage are likely subtle between prehypertension and stage I hypertension, although women with stage I hypertension had significantly higher LV mass, which may indicate sex-specific adaptive response to blood pressure in earlier stages of hypertension.
