Hypertension-mediated Cardiac Damage Among Romanian Adult Hypertensive Patients: A Post-hoc Echocardiographic Analysis of the SEPHAR IV Epidemiological Survey
, , , , , , , , , , , y | 18 mar 2023
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Article Category: Original Article
Publicado en línea: 18 mar 2023
Páginas: 6 - 13
DOI: https://doi.org/10.2478/rjc-2023-0001
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© 2023 Aura Vîjîiac et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Figure 1
Characteristics of hypertensive subjects with and without LVH
| Hypertensives with LVH (n=136) | Hypertensives without LVH (n=306) | p-value | |
|---|---|---|---|
| Female, n (%) | 93 (68.4%) | 155 (50.7%) | <0.001 |
| Age (years) | 66.1 (10.3) | 57.6 (13.2) | <0.001 |
| Rural residence, n (%) | 66 (48.5%) | 164 (53.6%) | 0.33 |
| Active smoking, n (%) | 20 (14.7%) | 73 (23.9%) | 0.03 |
| Dyslipidemia, n (%) | 68 (50.0%) | 144 (47.1%) | 0.57 |
| Diabetes, n (%) | 33 (24.3%) | 40 (13.1%) | 0.003 |
| Obesity, n (%) | 71 (55.9%) | 165 (53.9%) | 0.70 |
| Obstructive sleep apnea, n (%) | 6 (4.4%) | 11 (3.6%) | 0.68 |
| Systolic BP (mm Hg) | 145 (18) | 138 (17) | <0.001 |
| Diastolic BP (mm Hg) | 88 (11) | 88 (10) | 0.99 |
Multinomial logistic regression for predicting various patterns of LV remodelling
| Pattern of LV remodelling | Risk factor | B | SE | p | OR (95% CI) |
|---|---|---|---|---|---|
| Concentric remodelling | Age | 0.027 | 0.012 | 0.026 | 1.028 (1.003 – 1.052) |
| Male sex | −0.731 | 0.281 | 0.009 | 0.481 (0.278 – 0.834) | |
| Eccentric hypertrophy | Age | 0.064 | 0.017 | <0.001 | 1.066 (1.030 – 1.103) |
| Male sex | −0.976 | 0.355 | 0.006 | 0.377 (0.188 – 0.755) | |
| Concentric hypertrophy | Age | 0.056 | 0.018 | 0.002 | 1.058 (1.021 – 1.096) |
| Male sex | −1.131 | 0.376 | 0.003 | 0.323 (0.154 – 0.675) |
Characteristics of hypertensive subjects with and without LV dysfunction
| Hypertensives with DD (n=218) | Hypertensives without DD (n=224) | p-value | Hypertensives with SD (n=27) | Hypertensives without SD (n=415) | p-value | |
|---|---|---|---|---|---|---|
| Female, n (%) | 122 (56.0%) | 126 (56.3%) | 0.95 | 7 (25.9%) | 241 (58.1%) | 0.001 |
| Age (years) | 63.3 (10.6) | 57.2 (14.3) | <0.001 | 64.2 (14.1) | 59.9 (12.9) | 0.13 |
| Rural residence, n (%) | 103 (47.2%) | 127 (56.7%) | 0.047 | 8 (29.6%) | 222 (53.5%) | 0.02 |
| Active smoking, n (%) | 45 (20.6%) | 48 (21.4%) | 0.84 | 8 (29.6%) | 85 (20.5%) | 0.26 |
| Dyslipidemia, n (%) | 107 (49.1%) | 105 (46.9%) | 0.64 | 14 (51.9%) | 198 (47.7%) | 0.68 |
| Diabetes, n (%) | 45 (20.6%) | 28 (12.5%) | 0.02 | 9 (33.3%) | 64 (15.4%) | 0.02 |
| Obesity, n (%) | 123 (56.4%) | 113 (50.4%) | 0.21 | 11 (40.7%) | 225 (54.2%) | 0.17 |
| OSA, n (%) | 9 (4.3%) | 8 (3.6%) | 0.76 | 0 (0%) | 17 (4.1%) | 0.61 |
| Systolic BP (mm Hg) | 142 (18) | 139 (16) | 0.056 | 142 (22) | 140 (17) | 0.64 |
| Diastolic BP (mm Hg) | 88 (11) | 88 (10) | 0.47 | 88 (14) | 88 (10) | 0.96 |
Characteristics of hypertensive subjects with and without CAD
| Hypertensives with CAD (n=148) | Hypertensives without CAD (n=294) | p-value | |
|---|---|---|---|
| Female, n (%) | 78 (52.7%) | 170 (57.8%) | 0.31 |
| Age (years) | 64.9 (12.2) | 57.8 (12.7) | <0.001 |
| Rural residence, n (%) | 84 (56.8%) | 146 (49.7%) | 0.16 |
| Active smoking, n (%) | 30 (20.3%) | 63 (21.4%) | 0.78 |
| Dyslipidaemia, n (%) | 88 (59.5%) | 124 (42.2%) | <0.001 |
| Diabetes, n (%) | 37 (25.0%) | 36 (12.2%) | <0.001 |
| Obesity, n (%) | 76 (51.4%) | 160 (54.4%) | 0.54 |
| Obstructive sleep apnoea, n (%) | 10 (6.8%) | 7 (2.4%) | 0.02 |
| Systolic BP (mm Hg) | 142 (19) | 139 (17) | 0.19 |
| Diastolic BP (mm Hg) | 87 (11) | 89 (11) | 0.14 |
Multivariable logistic regression analysis for predictors of various forms of cardiac damage
| LVH | Diastolic dysfunction | Systolic dysfunction | CAD | |||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | |
| Age | 1.05 (1.03-1.08) | 1.04 (1.02-1.06) | 1.04 (0.99-1.08) | 0.115 | 1.05 (1.02-1.07) | |||
| Female sex | 2.07 (1.24-3.45) | 1.10 (0.71-1.69) | 0.681 | 0.26 (0.10-0.71) | 0.72 (0.45-1.14) | 0.161 | ||
| Dyslipidemia | 1.20 (0.74-1.96) | 0.465 | 0.98 (0.65-1.50) | 0.941 | 1.31 (0.52-3.31) | 0.564 | 1.89 (1.20-3.00) | |
| Diabetes | 1.63 (0.87-3.04) | 0.127 | 1.31 (0.74-2.33) | 0.361 | 2.20 (0.82-5.88) | 0.117 | 1.52 (0.85-2.71) | 0.161 |
| Smoking | 0.90 (0.64-1.25) | 0.514 | 1.27 (0.97-1.67) | 0.082 | 1.30 (0.72-2.35) | 0.393 | 1.04 (0.77-1.40) | 0.804 |
| OSA | 1.25 (0.41-3.86) | 0.697 | 0.96 (0.33-2.76) | 0.935 | 1.00 (0.99 -1.01) | 0.998 | 0.30 (0.10-0.94) | |
| Systolic BP | 1.02 (1.01-1.04) | 1.01 (0.99-1.02) | 0.433 | 1.00 (0.97-1.03) | 0.957 | 1.00 (0.99-1.02) | 0.621 | |
| Diastolic BP | 1.00 (0.97-1.03) | 0.886 | 1.00 (0.98-1.03) | 0.985 | 1.00 (0.94-1.06) | 0.905 | 1.00 (0.97-1.03) | 0.730 |
Clinical and echocardiographic characteristics of the study population.
| All subjects (n=976) | Hypertensive subjects (n=442) | Normotensive subjects (n=534) | p-value | |
|---|---|---|---|---|
| Female, n (%) | 580 (59.4%) | 248 (56.1%) | 332 (62.2%) | 0.055 |
| Age (years) | 50.8 (16.6) | 60.2 (13.0) | 43.0 (15.1) | <0.001 |
| Rural residence, n (%) | 456 (46.7%) | 230 (52.1%) | 226 (42.3%) | 0.002 |
| Active smoking, n (%) | 276 (28.3%) | 93 (21.0%) | 183 (34.3%) | <0.001 |
| Dyslipidemia, n (%) | 341 (34.9%) | 212 (48.0%) | 129 (24.2%) | <0.001 |
| Diabetes, n (%) | 91 (9.3%) | 73 (16.5%) | 18 (3.4%) | <0.001 |
| Obesity, n (%) | 391 (40.1%) | 236 (53.4%) | 155 (29.0%) | <0.001 |
| Obstructive sleep apnea, n (%) | 28 (2.9%) | 17 (3.8%) | 11(2.1%) | 0.10 |
| Systolic BP (mm Hg) | 129 (19) | 141 (17) | 119 (12) | <0.001 |
| Diastolic BP (mm Hg) | 83 (10) | 88 (11) | 78 (8) | <0.001 |
| IVS (mm) | 9 (1) | 10 (1) | 9 (1) | <0.001 |
| LVPW (mm) | 9 (1) | 10 (1) | 9 (1) | <0.001 |
| LVEDD (mm) | 45 (5) | 46 (5) | 44 (5) | <0.001 |
| LVESD (mm) | 34 (6) | 35 (6) | 33 (5) | <0.001 |
| LA diameter (mm) | 34 (5) | 36 (5) | 32 (5) | <0.001 |
| Indexed LV mass (g/m2) | 84 (24) | 94 (25) | 76 (20) | <0.001 |
| LVH, n (%) | 187 (19.2%) | 136 (30.8%) | 51 (9.6%) | <0.001 |
| Mitral E/A wave ratio | 1.23 (0.40) | 1.08 (0.37) | 1.35 (0.37) | <0.001 |
| Diastolic dysfunction | <0.001 | |||
| First degree, n (%) | 268 (27.5%) | 174 (39.4%) | 94 (17.6%) | |
| Second degree, n (%) | 87 (8.9%) | 40 (9.0%) | 47 (8.8%) | |
| Third degree, n (%) | 6 (0.6%) | 4 (0.9%) | 2 (0.4%) | |
| Systolic dysfunction, n (%) | 44 (4.5%) | 27 (6.1%) | 17 (3.2%) | 0.03 |
| LVEF (%) | 58 (4) | 57 (4) | 59 (4) | <0.001 |
| Atrial fibrillation, n (%) | 80 (8.2%) | 55 (12.4%) | 25 (4.7%) | <0.001 |