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Left ventricular mass versus pulse wave velocity as predictors of coronary artery disease in hypertensive patients: data from a 6-year-follow-up study

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Abstract

In treated hypertensive patients, there is a substantial residual cardiovascular (CV) risk that cannot be assessed by the available prediction models. This risk can be associated with subclinical organ damage, such as increased left ventricular mass (LVM) and arterial stiffness. However, it remains unknown which of these two CV markers better predicts coronary artery disease (CAD). A prospective cohort study was used to answer the above question. The study sample consisted of 1033 patients with hypertension (mean age 55.6 years, 538 males) free of CAD at baseline, who were followed for a mean period of 6 years. At baseline, all subjects underwent a complete echocardiographic study and pulse wave velocity (PWV) measurement. Hypertensive individuals who developed CAD (2.8%) compared to those without CAD at follow-up, had a higher baseline LVM index (by 16.7 g/m2, p < 0.001), higher prevalence of left ventricular hypertrophy (LVH) (21% greater, p = 0.027) and greater prevalence of high PWV levels at baseline (21% greater, p = 0.019). Multivariate Cox regression analysis revealed that baseline age >65 years (HR = 2.067, p = 0.001), male gender (HR = 3.664, p = 0.001), baseline chronic kidney disease (HR = 2.020, p = 0.026), baseline diabetes mellitus (HR = 1.952, p = 0.015) and baseline LVH (HR = 2.124 p = 0.001) turned out to be independent predictors of CAD, whereas high PWV levels were not. LVH proved to be an independent prognosticator of CAD in contrast to arterial stiffness that was not related to CAD after accounting for established confounders. Therefore, LVM can reliably help physicians to identify high-risk hypertensives in whom an intensified therapeutic management is warranted.

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Fig. 1: Life table analysis for the incidence of coronary artery disease.

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Authors and Affiliations

  1. First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece

    Ioannis Andrikou, Kyriakos Dimitriadis, Dimitris Konstantinidis, Ioannis Leontsinis, Eirini Andrikou, Panagiotis Iliakis, Ioannis Liatakis, Eleni Manta, Nikos Karaminas, Panagiotis Tsioufis, Nikolaos Magkas, Georgios Georgiopoulos, Christina Chrysohoou, Costas Thomopoulos, Dimitrios Tousoulis & Costas Tsioufis

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  1. Ioannis Andrikou
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Correspondence to Costas Tsioufis.

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Andrikou, I., Dimitriadis, K., Konstantinidis, D. et al. Left ventricular mass versus pulse wave velocity as predictors of coronary artery disease in hypertensive patients: data from a 6-year-follow-up study. J Hum Hypertens 36, 617–621 (2022). https://doi.org/10.1038/s41371-021-00560-1

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