Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects.

TLDR

Cardiovascular complications are a major source of morbidity and mortality in hypertensive patients. The study aimed to determine the prevalence of cardiac anatomical and functional abnormalities in asymptomatic hypertensive patients using echocardiography. Echocardiographic evaluation was performed on 234 asymptomatic patients with mild‑to‑moderate hypertension. Echocardiography revealed that 61 % of subjects had increased ventricular septal/posterobasal free‑wall thickness, 5–7 % had enlarged left atrial, aortic root, or LV internal dimensions, 6 % had reduced mitral valve closing velocity, 15 % had reduced ejection fraction, 4 % had disproportionate septal thickening, and fewer than 10 % showed abnormalities on ECG or chest X‑ray, underscoring a high prevalence of cardiac abnormalities detectable by echo in asymptomatic hypertensive patients.

Abstract

Cardiovascular complications are a major source of morbidity and mortality in hypertensive patients. To assess the prevalence of anatomic and functional abnormalities of the heart in such patients, we studied 234 asymptomatic subjects with mild-to-moderate systemic hypertension by echocardiography. After adjusting the echocardiographic values for age and body surface area, we found abnormally increased ventricular septal and/or posterobasal free-wall thickness in 61% of the hypertensive subjects. We found increased left atrial, aortic root, and left ventricular internal dimension (at end-diastole) in 5-7%, and decreased mitral valve closing velocity (E-F slope) and left ventricular ejection fraction were noted in six and 15% of the subjects, respectively. Four percent of the patients had disproportionate septal thickening (i.e., ventricular septal-to-left ventricular free-wall thickness ratio greater than or equal to 1.3). In contrast to the high prevalence of cardiac abnormalities detected by echocardiography, less than 10% of the hypertensive subjects had abnormal 12-lead ECGs or abnormal chest x-rays. These findings demonstrate a high prevalence of cardiac abnormalities in a population of asymptomatic hypertensive subjects. These abnormalities can be detected by echocardiography before they are otherwise apparent.