Correlation of Prehypertension with Left Ventricular Mass Assessed by Cardiac Magnetic Resonance Imaging

Abstract

Introduction. The purpose of this observational cross-sectional study was to assess left ventricular mass (LVM) in prehypertensive individuals in comparison to normotensives and to determine if central blood pressure (BP) correlates better with LVM index (LVMI) than brachial BP. Methods and Result. Brachial and central BP measurements were completed at first visit and at 4 weeks in 65 healthy volunteers who were at least 40 years old and not on medication. Subjects were divided into two groups of normotensives and prehypertensives based on JNC-7 criteria and LVM was obtained using cardiac magnetic resonance imaging. Prehypertensives had significantly higher LVMI compared to normotensives (P < 0.01). Brachial and central BP also both positively correlate with LVMI (r = 0.460, P < 0.01; r = 0.318, P = 0.012, resp.) in both groups and neither method was superior to the other. After multivariate regression analysis and adjusting for cardiovascular risk factors, prehypertension remained an independent determinant of LVM. Conclusion. Prehypertension is associated with cardiovascular target organ damage, and central BP was not superior to brachial BP or vice versa for association with LVMI.

Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

“…On the other hand, Mousa et al [10] reported that there was no statistically significant difference in the BMI among the two groups being studied (prehypertensive and normotensive) included in their study.…”

“…also, the mean LVMI in the prehypertension patients was 98.6 ± 8.4 which was statistically significantly higher than the cases with normal BP (66.7 ± 8.7) (p< 0.001). Within the same context, Mousa et al [10] showed that the mean LVMI in the prehypertensive patients was 34.45±7.4 that was statistically significantly higher as compared to the normotensive group (29 ± 6) (p=0.002).…”

“…Women had greater aortic stiffening, as indicated by higher aortic characteristic impedance (Zc), which should translate into a greater rise in blood pressure from increased flow during LV ejection, according to another study that examined sex differences in arterial stiffness and ventriculararterial interactions in an older population (men and women) [10].…”

Prehypertension, the Risk of Hypertension and Events

“…Target organ damage might contribute to future CV events in addition to elevated BP in individuals with prehypertension compared with individuals with optimal BP. Prehypertension has been associated with several types of target organ damage: metabolic syndrome [28,43,44], increased left ventricular mass and left ventricular hypertrophy [44][45][46][47], left ventricular diastolic dysfunction [44,[47][48][49][50], coronary artery calcification [51,52], increased minimum coronary resistance [42], arterial stiffness [32], increased arterial intima-media thickness [53,54], retinal vascular alterations [55], microalbuminuria [56][57][58], hemorheological abnormalities [59], increased tissue plasminogen activator [60], carotid atherosclerosis [61], poor cognitive performance [62], subclinical inflammation [37,63], increased low density lipoprotein (LDL) oxidation in vivo [64], increased serum complement [65], excessive sympathetic response [66], and abnormalities in endothelial progenitor cells [67].…”