[PP.05.12] SUBCLINICAL ORGAN DAMAGE IN HYPERTENSIVE PATIENTS WITH HIGH CARDIOVASCULAR RISK – FACTORS CONTRIBUTING TO THE CHANGE OF LEFT VENTRICULAR MASS AND CAROTID INTIMA MEDIA THICKNESS

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Abstract

Objective:

The careful assessment of target organ damage is a vital part of the management of any patient with hypertension, particularly for those who are high risk.

Design and method:

We studied 143 participants (93 females). Each participant underwent asymptomatic organ damage: 12-lead electrocardiogram examinations, two-dimensional and Doppler echocardiographs, Doppler sonography of the carotid arteries, and laboratory investigations were prospectively followed for total and cardiovascular mortality and disease over a median of 7 years. In this paper, we analyzed factors contributing to the change of left ventricular mass (LVM) and carotid intimae medial thickness (IMT).

Results:

In the beginning of the study, the mean age was 63.1 ± 8 years, body mass index of 28.7 ± 3 kg/m2, office blood pressure of 158 ± 16.5 mmHg, LVM index of 139.2 ± 30.5 g/m2 (63.6% with LVH defined as LVMI>125 gm2), carotid IMT of 0.94 ± 0.2 mm (19.6% was > 0,9 mm) and presence of a plaque in 75 (52.4%) participants. Diabetes mellitus (DM) occurred in 23.1% of patients, impaired fasting glucose occurred in13.3% of patients, and the rate of hypercholesterolemia (defined as cholesterol >5 mmol/l) was 79.7%.

Results:

A reduction in the LVMI was achieved by 55.9%of patients and a reduction or non progression in the IMT was achieved by only 31%.

Results:

The change in ILVM was related to the average annual values of systolic blood pressure (SBP) during the follow-up (r = 0.182; p < 0.05), the presence of DM at the end of the follow-up (r = 0.17; p < 0.05), the mean value of the annual value of glucose in the blood (r = 0.251; p < 0.05), and the standard deviation of annual measured values of glucose (r = 0.197; p < 0.05). A change in the IMT correlated with the standard deviation of SBP (r = 0.17; p < 0.05) and DM at the beginning of our tracking (r = -0.179; p < 0.05). Basal values of lipid parameters and their changes in the course of monitoring was not correlated to the change in ILVM and IMT.

Conclusions:

Our results suggest that a regression of LVH and IMT depend on good and constant regulation of BP and the presence and regulation of diabetes mellitus.

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