[PP.01.26] DETERMINANTS OF CARDIAC REMODELING IN ARTERIAL HYPERTENSION

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Abstract

Objective:

Arterial hypertension is a highly prevalent risk factor for cardiovascular disease. It is associated with progressive cardiac remodeling which may finally evolve to heart failure. Knowing the determinants of this remodeling might improve the strategy for hypertension treatment and prevention of heart failure.

Design and method:

We studied a group of 139 hypertensive patients, aged 63 ± 12 years, with a history of maximum 5 years of hypertension. Patients were evaluated by clinical examination, blood tests, transthoracic echocardiography and 24-hour ambulatory blood pressure monitoring. Statistical analysis was performed using SPSS 19.0.

Results:

The prevalence of major cardiovascular risk factors in the study group was as follows: dyslipidemia −75%, obesity −50%, smoking −24%, diabetes mellitus −22%, impaired fasting glycaemia −35%. Two thirds of patients had a non-dipper profile of hypertension. Half of patients had at least mild left ventricular hypertrophy and almost one third had enlarged left atrium. Echocardiographic parameters of cardiac remodeling (left ventricular posterior wall and septal thickness, relative wall thickness, left atrium size) significantly correlated with average 24-hour values of blood pressure, systolic nighttime blood pressure, pulse pressure, systolic and diastolic blood pressure load and dipping profile (p < 0.01 for all).

Conclusions:

Cardiac remodeling is highly prevalent in arterial hypertension, even in the first years from diagnosis. It is correlated with several parameters recorded by 24-hour ambulatory blood pressure monitoring, which may constitute specific targets for tailored therapy.

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