Effect of Systolic Blood Pressure on Left Ventricular Structure and Function

Abstract

We aimed to estimate the effects of a lifelong exposure to high systolic blood pressure (SBP) on left ventricular (LV) structure and function using Mendelian randomization. A total of 5596 participants of the UK Biobank were included for whom cardiovascular magnetic resonance imaging and genetic data were available. Major exclusion criteria included nonwhite ethnicity, major cardiovascular disease, and body mass index >30 or <18.5 kg/m 2 . A genetic risk score to estimate genetically predicted SBP (gSBP) was constructed based on 107 previously established genetic variants. Manual cardiovascular magnetic resonance imaging postprocessing analyses were performed in 300 individuals at the extremes of gSBP (150 highest and lowest). Multivariable linear regression analyses of imaging biomarkers were performed using gSBP as continuous independent variable. All analyses except myocardial strain were validated using previously derived imaging parameters in 2530 subjects. The mean (SD) age of the study population was 62 (7) years, and 52% of subjects were female. Corrected for age, sex, and body surface area, each 10 mm Hg increase in gSBP was significantly ( P <0.0056) associated with 4.01 g (SE, 1.28; P =0.002) increase in LV mass and with 2.80% (SE, 0.97; P =0.004) increase in LV global radial strain. In the validation cohort, after correction for age, sex, and body surface area, each 10 mm Hg increase in gSBP was associated with 5.27 g (SE, 1.50; P <0.001) increase in LV mass. Our study provides a novel line of evidence for a causal relationship between SBP and increased LV mass and with increased LV global radial strain.

Obesity Phenotypes and Electrocardiographic Characteristics in Physically Active Males: CHIEF Study

“…As compared with Sokolow-Lyon-based ECG-LVH, Cornell-based ECG-LVH, which utilized a limb lead voltage in the criteria to reduce the effect of chest wall thickness on the signals received in precordial leads, has shown higher accuracy to echocardiographic LVH in young males (26). Among the components of metabolic syndrome, hyperglycemia and elevated BP were regarded as independent risk factors for the development of LVH (32)(33)(34). Similarly in the present study, we observed an association between higher BP and ECG-LVH in the obesity subgroup.…”

“…Among the components of metabolic syndrome, hyperglycemia and elevated BP were regarded as independent risk factors for the development of LVH ( 32 – 34 ). Similarly in the present study, we observed an association between higher BP and ECG-LVH in the obesity subgroup.…”

The UK Biobank imaging enhancement of 100,000 participants: rationale, data collection, management and future directions

“…These early findings could help us understand the mechanism through which vascular risk factors are related to neurodegenerative diseases, such as Alzheimer's disease 9 . A range of cardiovascular risk factors have also been associated with cardiac structure and function [66][67][68] , and other, less obvious, associations have been identified, such as with air pollution 69 , menopausal hormonal therapy 70 and lung function 71 . Novel findings are already emerging, for example diabetes has been shown to be associated with abnormal morphologies and function in all four heart chambers, whereas previously only the left ventricle was typically thought to be affected by diabetes 72 .…”

Left Ventricular Remodeling and Myocardial Work: Results From the Population-Based STAAB Cohort Study

“…However, the CH pattern is of high clinical relevance, and further dedicated studies in hypertensive patients need to provide additional insights. Arterial hypertension is one of the most prevalent cardiovascular risk factors and a major contributor to longterm changes in LV geometry (36,37,43,44). A higher prevalence of hypertension was seen with a deviation from normal LV geometry.…”