Five-year follow-up of blood pressure and left ventricular mass in children with different maternal histories of hypertension

AbstractObjectiveIn our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort.DesignCommunity prospective cohort study, follow-up of a case-control study in community.SubjectsPatients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension.ResultsA total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (β=4.874, p<0.0001) and the patients with persistent masked hypertension (β=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (β=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (β=1.634, p=0.015).ConclusionsPersistent masked hypertension in adolescents is associated with elevated left ventricular mass index.

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Effect of body weight changes on 24-hour blood pressure and left ventricular mass in hypertension: a 4-year follow-up

American Journal of Hypertension ◽

10.1016/s0895-7061(03)00894-x ◽

2003 ◽

Vol 16 (8) ◽

pp. 634-639 ◽

Cited By ~ 15

Author(s):

G Schillaci

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Weight Changes ◽

Body Weight Changes ◽

Ventricular Mass

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Correlation between 24-hour profile of blood pressure and ventricular arrhythmias and their prognostic significance in patients with arterial hypertension

Vojnosanitetski pregled ◽

10.2298/vsp0805353d ◽

2008 ◽

Vol 65 (5) ◽

pp. 353-358

Author(s):

Dragan Djordjevic ◽

Marina Deljanin-Ilic ◽

Ivan Tasic

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Left Ventricular Mass ◽

Ventricular Arrhythmias ◽

Left Ventricular Mass Index ◽

Blood Pressure Monitoring ◽

Left Ventricular ◽

Ventricular Mass Index ◽

Ventricular Mass

Background/Aim. Left ventricular hypertrophy (LVH), apart from arterial hypertension, is a risk factor for electrophysiologic heart condition disorder and sudden cardiac death. The aim of this study was to examine a relationship between complex ventricular arrhythmias and parameters of 24-hour ambulatory blood pressure monitoring in the patients with arterial hypertension and left ventricular hypertrophy (LVH), as well as their prognostic significance during a five-year follow-up. Methods. Ninety patients with arterial hypertension and LVH were included in this study (mean age 55.2?8.3 years). There were 35 healthy people in the control group (mean age 54.5?7.1 years). Left ventricular mass index was 171.9?32.4 g/m2 in the LVH group and 102.4?13.3 g/m2 in the control group. Clinical examination, echocardiogram, 24-hour ambulatory blood pressure monitoring and 24-hour holter monitoring were done in all of the examined persons. Ventricular arrhythmias were classified by the Lown classification. Results. In the LVH group there were 54 (60.0%) of the patients with ? III Lown class. The best predictor of a Lown class were left ventricular mass index by using multivariate stepwise regression analyses (? = 0.212; p < 0.05) and small decrease of diastolic blood pressure during the night (? = -0.293; p < 0.01). The main predictor of bad prognosis was left ventricular mass index during a five year follow-up (? = 0.302; p < 0.01, for stepwise regression model: F = 8.828; p < 0.01, adjusted R2 = 0.091). Conclusion. Left ventricular arrhythmias are frequent in patients with lower decrease of blood pressure during the night. There was no correlation between the degree of ventricular arrhythmias and parameters from 24-hour blood pressure monitoring and a five-year prognosis in the patients with arterial hypertension and LVH. A bad five-year follow-up outcome of hypertensive disease depends on left ventricular mass index.

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Effects of blood pressure lowering and metabolic control on systolic left ventricular function in Type II diabetes mellitus

Clinical Science ◽

10.1042/cs20050367 ◽

2006 ◽

Vol 111 (1) ◽

pp. 53-59 ◽

Cited By ~ 10

Author(s):

Niels H. Andersen ◽

Steen H. Poulsen ◽

Per L. Poulsen ◽

Søren T. Knudsen ◽

Kjeld Helleberg ◽

...

Keyword(s):

Blood Pressure ◽

Strain Rate ◽

Metabolic Control ◽

Left Ventricular Mass ◽

Type Ii Diabetes ◽

Type Ii Diabetes Mellitus ◽

Left Ventricular ◽

Type Ii ◽

Ventricular Mass

Decreased left ventricular long-axis function may be the earliest stage in subclinical heart failure in Type II diabetes. To assess whether a decrease in SBP (systolic blood pressure) or a change in metabolic control would improve the long-axis function, 48 Type II diabetic patients participating in the CALM II (Candesartan and Lisinopril Microalbuminuria II) study were included in the present study. Patients were examined with tissue Doppler echocardiography at baseline and after 3 and 12 months of follow-up. Corresponding blood pressure, fructosamine and HbA1c (glycated haemoglobin) values were obtained. During the follow-up period, a decrease in SBP of 8 mmHg was seen (from 141±11 mmHg at baseline to 133±12 mmHg; P<0.001) and the peak systolic strain rate was significantly improved (from −1.10±0.25 at baseline to −1.25±0.22; P<0.01). There was a highly significant relationship between the changes in systolic strain rate, HbA1c (P<0.001) and fructosamine (P<0.05), and similarly to changes in left ventricular mass (P<0.05), whereas the correlation to the SBP reduction was not significant. Patients with improved glycaemic control, defined as a reduced HbA1c value after 12 months of follow-up, had a significantly improved strain rate (from −1.07±0.3 s−1 at baseline to −1.32±0.25 s−1; P<0.01) compared with patients with increases in HbA1c (from −1.14±0.25 s−1 at baseline to −1.16±0.27 s−1; P=not significant). The two groups had comparable baseline values of SBP, left ventricular mass, age and disease duration. In conclusion, changes in left ventricular systolic long-axis function are significantly correlated with changes in left ventricular mass, as well as metabolic control, in hypertensive patients with Type II diabetes mellitus.

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Blood pressure response in exercise is associated with future cardiac structural alterations in hypertensive patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.2708 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Andrikou ◽

K Dimitriadis ◽

I Andrikou ◽

A Kasiakogias ◽

F Tatakis ◽

...

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Cox Regression ◽

Blood Pressure Response ◽

Left Ventricular ◽

Pressure Response ◽

Outcome Variable ◽

Cox Regression Analysis ◽

Ventricular Mass

Abstract Background/Introduction Exaggerated blood pressure response (EBPR) during the exercise treadmill test (ETT) is often observed in individuals without known cardiovascular disease. Although it is generally considered as an abnormal response and a risk factor for hypertension development, its clinical significance remains controversial. On the other hand, regression of left ventricular hypertrophy (LVH) is independently associated with improved cardiovascular outcome. Purpose In this study we aimed to investigate the role of EBPR during exercise in LVH regression in hypertensive subjects over time. Methods 1413 hypertensive subjects, (mean age 57±11 years), 51% males, with baseline office blood pressure (BP) 144/89mmHg were followed for a mean period of 6.4±3.0 years. At baseline and last follow-up visit all patients underwent office BP, laboratory tests and echocardiographical determination of left ventricular mass index (LVMI). At baseline, all subjects underwent treadmill exercise testing (Bruce protocol) in order to identify the presence of EBPR based on the systolic BP elevation at peak exercise (> or =210 mmHg for men and > or =190 mmHg for women). Main outcome variable was LVH Regression/prevention (LVH Regr/prev), defined as: LVH at baseline visit with normal LVMI values at last visit or absence of LVH at baseline and last visit. BP control was considered optimal when the mean of office BP measurements during follow-up was <140/90mmHg. Results 46% of study population presented LVH Regr/prev during follow-up period. Cox-regression analysis, after adjustment for clinical and biochemical variables, revealed that low levels of baseline LVMI (HR=0.98, 95% CI 0.97–0.99, p<0.0001), absence of EBPR (HR=0.81, 95% CI 0.67–0.98, p=0.02) and optimal BP control during follow-up (HR=1.19, 95% CI 1.01–1.56, p=0.03) were independent predictors of LVH Regr/prev during follow-up. Conclusions Beyond optimal BP control, EBPR is a significant predictor of left ventricular mass changes overtime. Hence, ETT can provide clinical relevant information, including EBPR, which may help in the improvement of risk stratification of hypertensive subjects. Funding Acknowledgement Type of funding source: None

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Two-Year Change in Blood Pressure Status and Left Ventricular Mass Index in Chinese Children

Frontiers in Medicine ◽

10.3389/fmed.2021.708044 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zilin Li ◽

Yao Duan ◽

Min Zhao ◽

Costan G. Magnussen ◽

Bo Xi

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Left Ventricular Mass Index ◽

Target Organ Damage ◽

Early Time ◽

Left Ventricular ◽

Chinese Children ◽

Ventricular Mass Index ◽

Ventricular Mass

Background: Elevated blood pressure (BP) is associated with target organ damage, such as left ventricular hypertrophy (LVH), in childhood. However, it is unclear if children who resolve elevated BP have reduced levels of left ventricular mass index (LVMI). This study aimed to examine the association between change in BP status over 2 years and LVMI among Chinese children.Methods: Data were from 1,183 children aged 6–11 years at baseline in 2017 who were followed up in 2019 in the Huantai Childhood Cardiovascular Health Cohort Study. Change in BP status over 2 years from baseline to follow-up was categorized as: persistent normal BP, resolved elevated BP (elevated BP at baseline, normal BP at follow-up), incident elevated BP (normal BP at baseline, elevated BP at follow-up), and persistent elevated BP. Elevated BP status was defined according to national reference standards as systolic or diastolic BP levels ≥ sex-, age-, and height-specific 95th percentiles.Results: LVMI levels were lowest in children with persistent normal BP (30.13 g/m2.7), higher in those with incident elevated BP (31.27 g/m2.7), and highest in those with persistent elevated BP (33.26 g/m2.7). However, LVMI levels in those who had resolved elevated BP (30.67 g/m2.7) were similar to those with persistent normal BP. In the fully adjusted model, compared with children with persistent normal BP, those with persistent elevated BP and incident elevated BP had higher LVMI at follow-up (ß = 3.131, p < 0.001; ß = 1.143, p = 0.041, respectively). In contrast, those who had resolved elevated BP did not have a significantly higher LVMI (ß = 0.545, p = 0.194) than those with persistent normal BP.Conclusion: Developing or maintaining elevated BP over a 2-year period in childhood associated with higher levels of LVMI, but those able to resolve their elevated BP status over the same period had LVMI levels that were similar with those who had normal BP at both time points. Thus, it is important to identify children with elevated BP at early time and to take effective measures to lower their BP levels, thereby reducing high LVMI levels and related cardiovascular diseases in the future.

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