PREVALENCE AND DETERMINANTS OF ECHOCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY AMONG HYPERTENSIVE PATIENTS IN A TERTIARY CARE HOSPITAL


Anugya Aparajita Behera, Priyambada Panda, Dipti Mohapatra, Suresh Kumar Behera, Arati Mohanty

Abstract


 Objectives: This cross-sectional study was conducted during the year 2014–15 to determine the prevalence, pattern, and factors associated with left ventricular hypertrophy (LVH) among hypertensive patients attending a tertiary care hospital.

Methods: A total of 400 eligible adult patients having essential hypertension were included in this study. After obtaining informed consent, all participants were examined with echocardiography and relevant information was collected using a well-structured questionnaire.

Results: The mean age of study population was 52.3 ± 12.8 in years. Mean systolic (SBP) and diastolic blood pressure (DBP) was 149.8 ± 11.2 and 94.7 ± 4.9 mmHg, respectively. Among the study participants, 266 (66.5%) had LVH and concentric hypertrophy was the predominant (64.3%) LV geometric pattern. Multivariate logistic regression revealed that obesity, SBP, and DBP had significant positive association with LVH (p<0.05).

Conclusion: Liberal use of echocardiography in hypertensive patients could be useful in early diagnosis of LVH and guiding treatment decision. There should be emphasis on controlling SBP, DBP, and body mass index of hypertensive patients so that further cardiovascular complications can be prevented.


Keywords


Left ventricular hypertrophy, Hypertension, Echocardiography, Geometric pattern.

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References


WHO. WHO Cardiovascular Diseases (CVDs). Cardiovascular Diseases (CVDs); 2015. Available from: http://www.who.int/ mediacenter/factsheets/fs317en.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J, et al. Global burden of hypertension: Analysis of worldwide data. Lancet 2005;365:217-23.

Soubra L, Nureddin H, Omar AG, Saleh M. Factors associated with hypertension prevalence and control among lebanese Type 2 diabetic patients. Int J Pharm Pharm Sci 2016;8:153-9.

Cushman WC, Evans GW, Byington RP, David C, Grimm RH, Cutler JA, et al. Effects of intensive blood-pressure control in Type 2 diabetes mellitus. Engl J Med 2010;362:1575-85. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMoa1001286.

WHO. Preventing Chronic Disease: A Vital Investment. Geneva: World Health; 2005. p. 13.

Gupta R. Trends in hypertension epidemiology in India. Hum Hypertens 2004;18:73-8. Available from: http://www.nature.com/ doifinder/10.1038/sj.jhh.1001633.

Jose A, Wilson D, George M, Thomas RK, Justin A. Comparative study on the beneficial effects of telmisartan and other antihypertensive agents in stroke patients. Int J Pharm Pharm Sci 2017;9:99. Available from: http://www.innovareacademics.in/journals/index.php/ijpps/ article/view/15755.

Dahlof B, Devereux BR, Kjeldsen SE. Cardiovascular morbidity and mortality in the losartan intervention for end point reduction in hypertension study (LIFE): A randomised trial against atenolol. ACC Curr J Rev 2002;11:26. Available from: http://www.linkinghub.elsevier. com/retrieve/pii/S1062145802007778.

Sforza VF. European society of hypertension – European society of cardiology guidelines for the management of arterial hypertension. A J Hypertens 2003;21:1011-54.

Sundström J, Lind L, Arnlöv J, Zethelius B, Andrén B, Lithell HO. Echocardiographic and electrocardiographic diagnoses of left ventricular hypertrophy predict mortality independently of each other in a population of elderly men. Circulation 2001;103:2346-51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11352882.

Ruilope LM, Schmieder RE. Left ventricular hypertrophy and clinical outcomes in hypertensive patients. Am J Hypertens 2008;21:500-8. Available from: https://www.academic.oup.com/ajh/article-lookup/ doi/10.1038/ajh.2008.16.

Barrios V, Escobar C, Calderon A, Ribas L, Marti D, Asin E, et al. Prevalence of left ventricular hypertrophy detected by cornell voltage-duration product in a hypertensive population. Blood Press 2008;17:110-5.

Lozano JV, Redon J, Cea-Calvo L, Fernandez-Perez C, Navarro J, Bonet A, et al. Left ventricular hypertrophy in the Spanish hypertensive population. The ERIC-HTA study. Rev Esp Cardiol 2006;59:136-42.

Mancia G, Carugo S, Grassi G, Lanzarotti A, Schiavina R, Cesana G, et al. Prevalence of left ventricular hypertrophy in hypertensive patients without and with blood pressure control: Data from the PAMELA population. Pressioni arteriose monitorate E loro associazioni. Hypertension 2002;39:744-9.

de Simone G, Devereux RB, Roman MJ, Alderman MH, Laragh JH. Relation of obesity and gender to left ventricular hypertrophy in normotensive and hypertensive adults. Hypertension 1994;23:600-6.

Hammond IW, Devereux RB, Alderman MH, Laragh JH. Relation of blood pressure and body build to left ventricular mass in normotensive and hypertensive employed adults. Am Coll Cardiol 1988;12:996-1004.

Ching SM, Chia YC, Wan Azman WA. Prevalence and determinants of left ventricular hypertrophy in hypertensive patients at a primary. Care Clin 2012;7:2-9.

Institute for Health Management, Ministry of Health Malaysia. A study on the adequacy. Outpatient Management of Essential Hypertension in MOH Hospitals and Health Centres. Sydney: Institute for Health Management; 2006.

Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of left-ventricular hypertrophy in hypertension: An updated review of echocardiographic studies. Hum Hypertens 2012;26:343-49. Available from: http://www.nature.com/doifinder/10.1038/jhh.2011.104.

NICE Guidance. BMI: Preventing Ill Health and Premature Death in Black, Asian and Other Minority Ethnic Groups; 2013. Available from: https://www.nice.org.uk/guidance/ph46/chapter/1-recommendations. [Last cited on 2017 Sep 30].

Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known 1916. Nutrition 1989;5:303-11.

Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelli WP, et al. Echocardiographic criteria for left ventricular hypertrophy: The framingham heart study. Am J Cardiol 1987;59:956- 60.

Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am J Cardiol 1986;57:450-8. Available from: http://www.sci-hub.bz/10.1016/0002-9149(86)90771- x%5Cnhttp://www.sciencedirect.com/science/article/B6T10- 4C7097R-WB/2/4199faad332cc441e1dd612c3ad637b9.

Iwashima Y, Horio T, Kamide K, Tokudome T, Yoshihara F, Nakamura S, et al. Additive interaction of metabolic syndrome and chronic kidney disease on cardiac hypertrophy, and risk of cardiovascular disease in hypertension. Am J Hypertens 2010;23:290-8.

Yasuno S, Ueshima K, Oba K, Fujimoto A, Ogihara T, Saruta T, et al. Clinical significance of left ventricular hypertrophy and changes in left ventricular mass in high-risk hypertensive patients: A subanalysis of the candesartan antihypertensive survival evaluation in Japan trial. J Hypertens 2009;27:1705-12.

Castelpoggi CH, Pereira VS, Fiszman R, Cardoso CR, Muxfeldt ES, Salles GF, et al. A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension. Hypertens Res 2009;32:591-6.

Cuspidi C, Giudici V, Lonati L, Sala C, Valerio C, Mancia G, et al. Left ventricular hypertrophy detection and body mass index in essential hypertension. Blood Press 2010;19:337-43.

Cuspidi C, Ambrosioni E, Mancia G, Pessina AC, Trimarco B, Zanchetti A, et al. Role of echocardiography and carotid ultrasonography in stratifying risk in patients with essential hypertension: The assessment of prognostic risk observational survey. J Hypertens 2002;20:1307-14.

Viazzi F, Parodi D, Leoncini G, Parodi A, Falqui V, Ratto E, et al. Serum uric acid and target organ damage in primary hypertension. Hypertension 2005;45:991-6.

Tsioufis CP, Tsiachris DL, Selima MN, Dimitriadis KS, Thomopoulos CG, Tsiliggiris DC, et al. Impact of waist circumference on cardiac penotype in hypertensives according to gender. Obesity 2009;17:177-82.

Ganau A, Devereux RB, Roman MJ, de Simone G, Pickering TG, Saba PS, et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 1992;19:1550-8.

Schillaci G, Verdecchia P, Porcellati C, Cuccurullo O, Cosco C, Perticone F, et al. Continuous relation between left ventricular mass and cardiovascular risk in essential hypertension. Hypertension 2000;35:580-6.

Haider AW, Larson MG, Benjamin EJ, Levy D. Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. Am Coll Cardiol 1998;32:1454-59.

Shipilova T, Pshenichnikov I, Kaik J, Volozh O, Abina J, Kalev M, et al. Echocardiographic assessment of the different left ventricular geometric patterns in middle-aged men and women in tallinn. Blood Press 2003;12:284-90.

Potu C, Tulloch-Reid E, Baugh D, Ismail OA, Madu EC. Echocardiographic partition values and prevalence of left ventricular hypertrophy in hypertensive jamaicans. Eur J Cardiovasc Med 2012;2:70-7. Available from: http://www.healthcare-bulletin. com/journals/cardiovascular-medicine/the-european-journal-of-cardiovascular-medicine/details/article/echocardiographic-partition-values-and-prevalence-of-left-ventricular-hypertrophy-in-hypertensive-ja/.

Patel DA, Lavie CJ, Artham SM, Milani RV. Cardenas GA, Ventura HO. Effects of left ventricular geometry and obesity on mortality in women with normal ejection fraction. Am J Cardiol 2014;113:877-80. Available from: http://www.linkinghub.elsevier.com/retrieve/pii/ S0002914913023862.

Adebiyi AA, Ogah OS, Aje A, Ojji DB, Adebayo AK, Oladapo OO, et al. Echocardiographic partition values and prevalence of left ventricular hypertrophy in hypertensive Nigerians. BMC Med Imaging 2006;6:10. Available from: http://www.bmcmedimaging.biomedcentral.com/ articles/10.1186/1471-2342-6-10.

Wachtell K, Bella JN, Liebson PR, Gerdts E, Dahlöf B, Aalto T, et al. Impact of different partition values on prevalences of left ventricular hypertrophy and concentric geometry in a large hypertensive population : The LIFE study. Hypertension 2000;35:6-12.

Akintunde A, Akinwusi O, Opadijo G. Left ventricular hypertrophy, geometric patterns and clinical correlates among treated hypertensive nigerians. Pan Afr Med J 2010;4:8.

Choi D, Hwang KC, Lee KY, Kim YH. Ischemic heart diseases: Current treatments and future. J Control Release 2009;140:194-202.

Schirmer H, Lunde P, Rasmussen K. Prevalence of left ventricular hypertrophy in a general population; The tromsø study. Eur Heart J 1999;20:429-38.

Salvetti G, Pucci A, Fierabracci P, Ceccarini G, Palagi C, Donne MGD, et al. Prevalence of left ventricular hypertrophy and determinants of left ventricular mass in obese women. High Blood Press Cardiovasc Prev 2012;19:33-9. Available from: http://www.scopus.com/inward/record. url?eid=2-s2.0-84861950539&partnerID=40&md5=a2d401c7cc80138 805c9337b9607f147.

Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry. The framingham heart study. JAMA 1991;266:231-6.

Chadha DS, Gupta N, Goel K, Pandey RM, Kondal D, Ganjoo RK, et al. Impact of obesity on the left ventricular functions and morphology of healthy asian indians. Metab Syndr Relat Disord 2009;7:151-8.

Wong CY, O’Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH, et al. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation 2004;110:3081-7.

Kathrotia RG, Paralikar SJ, Rao PV, Oommen ER. Impact of different grades of body mass index on left ventricular structure and function. Indian J Physiol Pharmacol 2010;54:149-56.

Alpert MA. Obesity cardiomyopathy: Pathophysiology and evolution of the clinical syndrome. Am J Med Sci 2001;321:225-36.

Zhang K, Chen J, Liu Y, Wang T, Wang L, Wang J, et al. Diastolic blood pressure reduction contributes more to the regression of left ventricular hypertrophy: A meta-analysis of randomized controlled trials. Hum Hypertens 2013;27:698-706. Available from: http://www.nature.com/ doifinder/10.1038/jhh.2013.20.

de Lima JJ, Abensur H, Edurado MK, Fulvio P. Arterial blood pressure and left ventricular hypertrophy in haemodialysis patients. J Hypertens 1996;14:1019-24.

Li H, Pei F, Shao L, Chen J, Sun K, Zhang X, et al. Prevalence and risk factors of abnormal left ventricular geometrical patterns in untreated hypertensive patients. BMC Cardiovasc Disord 2014;14:136. Available from: http://www.pubmedcentral.nih.gov/articlerender. fcgi?artid=4192326&tool=pmcentrez&rendertype=abstract.

Gerdts E, Oikarinen L, Palmieri V, Otterstad JE, Wachtell K, Boman K,et al. Correlates of left atrial size in hypertensive patients with left ventricular hypertrophy: The losartan intervention for endpoint reduction in hypertension (LIFE) study. Hypertension 2002;39:739-43.

Okin PM, Gerdts E, Wachtell K, Oikarinen L, Nieminen MS, Dahlöf B, et al. Relationship of left atrial enlargement to persistence or development of ECG left ventricular hypertrophy in hypertensive patients: Implications for the development of new atrial fibrillation. Hypertens 2010;28:1534-40. Available from: http://www.content. wkhealth.com/linkback/

Tedesco MA, Di Salvo G, Ratti G, Natale F, Iarussi D, Iacono A. Left atrial size in 164 hypertensive patients: An echocardiographic and ambulatory blood pressure study. Clin Cardiol 2001;24:603-7.




About this article

Title

PREVALENCE AND DETERMINANTS OF ECHOCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY AMONG HYPERTENSIVE PATIENTS IN A TERTIARY CARE HOSPITAL

Keywords

Left ventricular hypertrophy, Hypertension, Echocardiography, Geometric pattern.

DOI

10.22159/ajpcr.2018.v11i4.22932

Date

01-04-2018

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 11 Issue 4 April 2018 Page: 56-60

Print ISSN

0974-2441

Online ISSN

2455-3891

Authors & Affiliations

Anugya Aparajita Behera
Department of Physiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
India

Priyambada Panda
Department of Physiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
India

Dipti Mohapatra
Department of Physiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
India

Suresh Kumar Behera
Department of Cardiology,Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
India

Arati Mohanty
Department of Physiology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, Odisha, India.
India


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