Left ventricular mass independently associates with masked hypertension in young healthy adults

Sekoba, Nare P; Kruger, Ruan; Labuschagne, Pieter; Schutte, Aletta E.

doi:10.1097/hjh.0000000000001740

Cited by 12 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings from this rural population align with data from periurban settings in South Africa and SSA, where a high hypertension burden led to widespread LVH (40%) and diastolic dysfunction (25%), even in young patients with masked hypertension. 4,7,22 Notably, diastolic dysfunction in our rural sample is greater than contemporary reports from high-income countries in Europe (10%-25%). 23 Some variability is expected because diastolic parameters vary across studies based on an evolving expert consensus.…”

Section: Discussioncontrasting

confidence: 58%

“…Such contemporary data are needed for health systems to identify high-risk patient groups to prioritize and target with aggressive monitoring and treatment. 7 To address this unmet need, in 2014, we began collecting epidemiological data on a cohort of >5000 individuals from the Health and Socio-Demographic Surveillance System established in the Agincourt subdistrict, in rural South Africa, 8 where we documented a high burden of hypertension and obesity. 6 However, the severity of this CVD burden-as evidenced by end-organ damage-has not been measured in this region.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Echocardiographic and Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa

Ferro

Abrahams‐Gessel²,

Jardim

et al. 2021

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

Background: Sub-Saharan Africa is undergoing an epidemiological transition fueled by the interaction between infectious and cardiovascular diseases. Our cross-sectional study aimed to characterize the spectrum of abnormalities suggesting end-organ damage on ECG and transthoracic echocardiograms (TTE) among older adults with cardiovascular diseases in rural South Africa. Methods: The prevalence of ECG and TTE abnormalities was estimated; χ 2 analyses and multivariable logistic regressions were performed to test their association with sex, hypertension, and other selected comorbidities. Results: Overall, 729 ECGs and 155 TTEs were completed, with 74 participants completing both. ECG evaluation showed high rates of left ventricular hypertrophy (LVH, 36.5%) and T wave abnormalities (13.6%). TTE evaluation showed high rates of concentric LVH (31.6%), with moderate-severe (56.8%) diastolic dysfunction. Participants with hypertension showed more cardiac remodeling on ECG by LVH (45.4% versus 22.1%, P <0.01), and TTE by concentric LVH (42.5% versus 8.2%, P <0.01) and increased left ventricular mass (58.5% versus 20.4%, P <0.0001). In multivariable logistic regression, systolic blood pressure remained significantly associated with LVH on ECG (adjusted odds ratio, 1.03 per mm Hg [95% CI, 1.03–1.04], P <0.0001) and increased left ventricular mass on TTE (adjusted odds ratio, 1.04 per mm Hg [95% CI, 1.01–1.06], P =0.001). Male participants (n=326, 40.2%) were more likely than females (n=484, 59.8%) to show ECG abnormalities like LVH (45% versus 30.8%, P <0.01), whereas females were more likely to show TTE abnormalities like concentric LVH (40.8% versus 13.5%, P <0.01) and increased left ventricular mass (58.4% versus 23.1%, P <0.0001). Similar results were confirmed in multivariable models. Conclusions: Our findings suggest that cardiovascular diseases are widespread in rural South Africa, with a larger burden of hypertensive heart disease than previously appreciated, and define the severity of end-organ damage that is already underway. Local health systems must adapt to face the growing burden of hypertension, as suboptimal rates of hypertension diagnosis and treatment may dramatically increase the heart failure burden.

show abstract

Section: Discussioncontrasting

confidence: 58%

mentioning

confidence: 99%

Echocardiographic and Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa

Ferro

Abrahams‐Gessel²,

Jardim

et al. 2021

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

show abstract

“… 28 Furthermore, despite their young age those with masked hypertension had a greater adjusted odds ratio (1.67, 95% confidence interval 1.05–2.71, P = 0.031) for increased left ventricular mass index. 29 …”

Section: Resultsmentioning

confidence: 99%

The African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT): Design, recruitment and initial examination

Schutte

Gona

Delles

et al. 2019

Eur J Prev Cardiolog

Self Cite

View full text Add to dashboard Cite

BackgroundGlobally hypertension is stabilising, but in sub-Saharan Africa the incidence of hypertension remains on an increase. Although this might be attributed to poor healthcare and ineffective antihypertensive treatment, there is a limited understanding of population and individual-specific cardiovascular pathophysiology – necessary for effective prevention and treatment strategies in Africa. As there is a lack of longitudinal studies tracking the early pathophysiological development of hypertension in black populations, the African-PREDICT study was initiated. The purpose of this paper is to describe the detailed methodology and baseline cohort profile of the study.Methods and resultsFrom 2013 to 2017, the study included 1202 black (N = 606) and white (N = 596) men and women (aged 20–30 years) from South Africa – screened to be healthy and clinic normotensive. At baseline, and each 5-year follow-up examination, detailed measures of health behaviours, cardiovascular profile and organ damage are taken. Also, comprehensive biological sampling for the ‘omics’ and biomarkers is performed. Overall, the baseline black and white cohort presented with similar ages, clinic and 24-hour blood pressures, but black adults had lower socioeconomic status and higher central systolic blood pressure than white individuals.ConclusionsThe prospective African-PREDICT study in young black and white adults will contribute to a clear understanding of early cardiovascular disease development.

show abstract

“…The present study identified MH in 32.1% and 55% of PLHIV with OBP normotension or high-normal BP, respectively. The identification of MH is very important, since patients with MH frequently develop target organ damage prior to transitioning to sustained hypertension and MH confers a cardiovascular risk similar to that of sustained hypertension [27][28][29]. Data on the frequency of MH among PLHIV are scarce and primarily from countries outside SSA (e.g.…”

Section: Discussionmentioning

confidence: 99%

24-h-Ambulatory Blood Pressure Monitoring in Sub-Saharan Africa: Hypertension Phenotypes and Dipping Patterns in Malawian HIV+ Patients on Antiretroviral Therapy

Kasper

Nhlema

Forest

et al. 2021

View full text Add to dashboard Cite

Background: Cardiovascular disease and especially hypertension are a growing problem among people living with HIV (PLHIV) on antiretroviral therapy (ART) in sub-Saharan Africa. Objectives: As robust data on hypertension phenotypes associated with distinct cardiovascular risks among PLHIV are limited, we aimed to assess the frequency of white-coat (WCH), masked (MH) hypertension, and blood pressure dipping-patterns in a group of Malawian PLHIV. Methods: As part of the prospective Lighthouse-Tenofovir-Cohort-Study, we analyzed clinical, laboratory and 24-h-ambulatory blood pressure monitoring (ABPM) data of PLHIV from urban Lilongwe with treated or untreated hypertension or raised office blood pressure (OBP) during routine study-visits. Results: 118 PLHIV were included and data of 117 participants could be analyzed. Twentyfour-hour ABPM normotension was found in a total of 73 PLHIV including 14/37 on antihypertensive treatment (37.8%). Using strict definitions, i.e. normal OBP plus normal mean BP for all periods of ABPM, controlled hypertension was found in only 4/37 (10.8%) PLHIV on antihypertensive treatment while true normotension was observed in 10/24 untreated patients (41.7%) with previously diagnosed hypertension and 22/56 patients (39.3%) without a medical history of hypertension. WCH with normal BP during all periods of 24-h-ABPM was identified in 12/64 OBP-hypertensive PLHIV (18.8%), primarily in patients with grade 1 hypertension (11/41 patients; 26.8%). MH was found in 17/53 PLHIV with OBP-normotension (32.1%), predominantly in patients with high normal BP (11/20 patients; 55%). The estimated glomerular filtration rate tended to be lower in MH compared to strictly defined normotensive PLHIV (92.0±20.4 vs. 104.8±15.7 ml/min/m²). 64.1 percent of PLHIV (59.5% with 24-h hypertension and 66.7% with 24-h normotension) had abnormal systolic dipping. Conclusion:The high prevalence of WCH and MH with signs of early renal end-organ damage and an abnormal dipping in approximately 2/3 of PLHIV warrants further investigation as these factors may contribute to the increased cardiovascular risk in PLHIV in resource-limited settings like Malawi. Clinical Trial Registration: https://clinicaltrials.gov (NCT02381275), registered March 6th, 2015.

show abstract

Left ventricular mass independently associates with masked hypertension in young healthy adults

Abstract: This study highlights the importance of the early detection of masked hypertension as young apparently healthy adults already show an increased left ventricular mass index, thereby indicating increased risk for future cardiovascular disease.

Cited by 12 publications

References 32 publications

Echocardiographic and Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa

Echocardiographic and Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa

The African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT): Design, recruitment and initial examination

24-h-Ambulatory Blood Pressure Monitoring in Sub-Saharan Africa: Hypertension Phenotypes and Dipping Patterns in Malawian HIV+ Patients on Antiretroviral Therapy

Contact Info

Product

Resources

About