Hypertension Effects on the Left Ventricle

Highlights from studies on the hypertension effects on the left ventricle, from posters presented at the 59th Annual Scientific Sessions of the ACC.

Adult Left Ventricular Mass Is Associated with Long-term Blood Pressure Variability Beginning in Childhood in Blacks, but not in Whites: The Bogalusa Heart Study

Researchers: Chen W, Ruan L, Srinivasan S, et al.

Purpose: To assess the hypothesis that long-term blood pressure (BP) “variability from childhood to adulthood, besides levels, is predictive of adulthood left ventricular mass (LVM)” in black individuals.

Results: With potential implications for preventive cardiology, variations in BP over the long term that reflect characteristics of stimulus response are predictive, among black individuals and independent of BP levels, of adult left ventricular hypertrophy.

Differential Effects of Ambulatory Isolated Systolic and Isolated Diastolic Hypertension in Cardiac Adaptations in the Early Stages of Hypertension Presentation

Researchers: Taxiarchou E, Tsioufis K, Roussos D, et al.

Purpose: To “investigate the interrelationship between specific ambulatory hypertensive patterns and alterations in cardiac structural and functional indexes,” as isolated systolic hypertension (ISH) “has been associated with adverse cardiovascular outcome compared to isolated diastolic hypertension (IDH) or systolic -diastolic hypertension (SDH),” and ambulatory blood pressure “is superior to office BP in predicting target organ damage.”

Results: Compared with ISH, IDH is associated with worsening left ventricular diastolic function in patients with essential hypertension, whereas the latter seems to be accompanied by more adverse structural cardiac adaptations. Future studies are needed, as the “pathophysiologic pathway linking these entities and the clinical significance of these findings remains to be elucidated.”

Chronic Kidney Disease and Left Ventricular Hypertrophy as Prognosticators of Cardiovascular Events in Hypertension

Researchers: Tsiachris D, Tsioufis K, Thomopoulos C, et al.

Purpose: To “distinguish the comparative prognostic role of left ventricular hypertrophy [LVH] and chronic kidney disease [CKD] for major CV events

Results: In patients with hypertension but whom have no cardiovascular disease, “CKD and LVH are both independent prognosticators of the composite end-point of all-cause death and CV morbidity, whereas LVH but not CKD is a major predictor for stroke. Moreover, their combination is accompanied by increased incidence of CAD, stroke and composite, further supporting the adverse prognosis associated with cardiorenal dysfunction.”

Myocardial Injury in Hypertensive Heart Presentation

Researchers: Yamamoto E, Sato Y, Miyamoto T, et al.

Purpose: To evaluate “the relationship between [N-terminal Pro-brain natriuretic peptide (NT-proBNP)] and heart-type fatty acid-binding protein (H-FABP) in hypertensive patients,” as slight elevations of NT-proBNP have been reported as predictors of cardiovascular events, myocyte injury biomarkers are elevated in patients with heart failure, and no correlation between these markers has been elucidated in patients with essential hypertension.

Results: “H-FABP is a significant factor that induced the elevation of NT-proBNP in [the] hypertensive heart without heart failure and ischemic etiology. These results suggest that there is myocardial injury in patients with essential hypertension.”

The results of several studies were presented on the topic of hypertension effects on the left ventricle. Here, we provide highlights of those that stood out.