Determinants of left ventricular diastolic dysfunction in hypertensive patients

R Nazário Leão, P Marques da Silva, R Marques Pocinho, M Alves, D Virella, R Palma Dos Reis

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: The progression of hypertensive heart disease leads to the left ventricular diastolic dysfunction (LVDD), which is associated with increased cardiovascular morbidity and mortality. The purpose of this analysis is to explore the determinants for LVDD in patients with hypertension.

METHODS: This is a secondary analysis of data of Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study. Mann-Whitney and Chi-square tests were used for univariable analysis. Multiple logistic regression was used to model for LVDD occurrence and discriminative capacity of the model assessed by the value of the area under the curve given by the receiver-operating characteristic curve.

RESULTS: Older age (65 vs. 58 years, p<0.001), longer duration of hypertension (160 vs. 48 months, p<0.001), uncontrolled hypertension (59.8 vs. 15.9%, p<0.001), tobacco smoking (17.8 vs. 3.8%, p=0.016), higher systolic blood pressure (133 vs. 124mmHg, p=0.001) and slower heart rate (62 vs. 66bpm, p=0.023) were associated with LVDD. Multivariate model identified uncontrolled hypertension (AdjOR 36.90; 95% CI 7.94-171.58; p<0.001), smoking (AdjOR 6.66; 95% CI 1.63-27.26; p=0.008), eccentric hypertrophy (AdjOR 3.59; 95% CI 0.89-14.39; p=0.072), duration of hypertension (AdjOR 1.03; 95% CI 1.02-1.05; p<0.001) and concentric remodeling (AdjOR 0.19; 95% CI 0.04-0.93; p=0.041) as the more determinant for occurrence of LVDD. The discriminative capacity of the model was AUC=0.95 (95% CI 0.91-0.98).

CONCLUSION: The occurrence of LVDD in hypertensive patients was strongly associated to long-lasting, uncontrolled hypertension, tobacco smoking, concentric remodeling and eccentric hypertrophy.

Original languageEnglish
Pages (from-to)160-168
Number of pages9
JournalHipertension y Riesgo Vascular
Volume35
Issue number4
Early online date2 Feb 2018
DOIs
Publication statusPublished - Oct 2018

Fingerprint

Left Ventricular Dysfunction
Hypertension
Smoking
Hypertrophy
Area Under Curve
Impedance Cardiography
Chi-Square Distribution
ROC Curve
Heart Diseases
Heart Rate
Logistic Models
Blood Pressure
Morbidity
Mortality

Keywords

  • Determinantes de la disfunción diastólica del ventrículo izquierdo
  • Diastolic dysfunction determinants
  • Disfunción diastólica del ventrículo izquierdo
  • Hipertensión arterial
  • Hypertension
  • Left ventricular diastolic dysfunction

Cite this

@article{8bf64a52351a4ce98b97131d28e84dbc,
title = "Determinants of left ventricular diastolic dysfunction in hypertensive patients",
abstract = "INTRODUCTION: The progression of hypertensive heart disease leads to the left ventricular diastolic dysfunction (LVDD), which is associated with increased cardiovascular morbidity and mortality. The purpose of this analysis is to explore the determinants for LVDD in patients with hypertension.METHODS: This is a secondary analysis of data of Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study. Mann-Whitney and Chi-square tests were used for univariable analysis. Multiple logistic regression was used to model for LVDD occurrence and discriminative capacity of the model assessed by the value of the area under the curve given by the receiver-operating characteristic curve.RESULTS: Older age (65 vs. 58 years, p<0.001), longer duration of hypertension (160 vs. 48 months, p<0.001), uncontrolled hypertension (59.8 vs. 15.9{\%}, p<0.001), tobacco smoking (17.8 vs. 3.8{\%}, p=0.016), higher systolic blood pressure (133 vs. 124mmHg, p=0.001) and slower heart rate (62 vs. 66bpm, p=0.023) were associated with LVDD. Multivariate model identified uncontrolled hypertension (AdjOR 36.90; 95{\%} CI 7.94-171.58; p<0.001), smoking (AdjOR 6.66; 95{\%} CI 1.63-27.26; p=0.008), eccentric hypertrophy (AdjOR 3.59; 95{\%} CI 0.89-14.39; p=0.072), duration of hypertension (AdjOR 1.03; 95{\%} CI 1.02-1.05; p<0.001) and concentric remodeling (AdjOR 0.19; 95{\%} CI 0.04-0.93; p=0.041) as the more determinant for occurrence of LVDD. The discriminative capacity of the model was AUC=0.95 (95{\%} CI 0.91-0.98).CONCLUSION: The occurrence of LVDD in hypertensive patients was strongly associated to long-lasting, uncontrolled hypertension, tobacco smoking, concentric remodeling and eccentric hypertrophy.",
keywords = "Determinantes de la disfunci{\'o}n diast{\'o}lica del ventr{\'i}culo izquierdo, Diastolic dysfunction determinants, Disfunci{\'o}n diast{\'o}lica del ventr{\'i}culo izquierdo, Hipertensi{\'o}n arterial, Hypertension, Left ventricular diastolic dysfunction",
author = "{Naz{\'a}rio Le{\~a}o}, R and {Marques da Silva}, P and {Marques Pocinho}, R and M Alves and D Virella and {Palma Dos Reis}, R",
note = "Copyright {\circledC} 2017 SEH-LELHA. Publicado por Elsevier Espa{\~n}a, S.L.U. All rights reserved.",
year = "2018",
month = "10",
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journal = "Hipertension y Riesgo Vascular",
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Determinants of left ventricular diastolic dysfunction in hypertensive patients. / Nazário Leão, R; Marques da Silva, P; Marques Pocinho, R; Alves, M; Virella, D; Palma Dos Reis, R.

In: Hipertension y Riesgo Vascular, Vol. 35, No. 4, 10.2018, p. 160-168.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Determinants of left ventricular diastolic dysfunction in hypertensive patients

AU - Nazário Leão, R

AU - Marques da Silva, P

AU - Marques Pocinho, R

AU - Alves, M

AU - Virella, D

AU - Palma Dos Reis, R

N1 - Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

PY - 2018/10

Y1 - 2018/10

N2 - INTRODUCTION: The progression of hypertensive heart disease leads to the left ventricular diastolic dysfunction (LVDD), which is associated with increased cardiovascular morbidity and mortality. The purpose of this analysis is to explore the determinants for LVDD in patients with hypertension.METHODS: This is a secondary analysis of data of Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study. Mann-Whitney and Chi-square tests were used for univariable analysis. Multiple logistic regression was used to model for LVDD occurrence and discriminative capacity of the model assessed by the value of the area under the curve given by the receiver-operating characteristic curve.RESULTS: Older age (65 vs. 58 years, p<0.001), longer duration of hypertension (160 vs. 48 months, p<0.001), uncontrolled hypertension (59.8 vs. 15.9%, p<0.001), tobacco smoking (17.8 vs. 3.8%, p=0.016), higher systolic blood pressure (133 vs. 124mmHg, p=0.001) and slower heart rate (62 vs. 66bpm, p=0.023) were associated with LVDD. Multivariate model identified uncontrolled hypertension (AdjOR 36.90; 95% CI 7.94-171.58; p<0.001), smoking (AdjOR 6.66; 95% CI 1.63-27.26; p=0.008), eccentric hypertrophy (AdjOR 3.59; 95% CI 0.89-14.39; p=0.072), duration of hypertension (AdjOR 1.03; 95% CI 1.02-1.05; p<0.001) and concentric remodeling (AdjOR 0.19; 95% CI 0.04-0.93; p=0.041) as the more determinant for occurrence of LVDD. The discriminative capacity of the model was AUC=0.95 (95% CI 0.91-0.98).CONCLUSION: The occurrence of LVDD in hypertensive patients was strongly associated to long-lasting, uncontrolled hypertension, tobacco smoking, concentric remodeling and eccentric hypertrophy.

AB - INTRODUCTION: The progression of hypertensive heart disease leads to the left ventricular diastolic dysfunction (LVDD), which is associated with increased cardiovascular morbidity and mortality. The purpose of this analysis is to explore the determinants for LVDD in patients with hypertension.METHODS: This is a secondary analysis of data of Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study. Mann-Whitney and Chi-square tests were used for univariable analysis. Multiple logistic regression was used to model for LVDD occurrence and discriminative capacity of the model assessed by the value of the area under the curve given by the receiver-operating characteristic curve.RESULTS: Older age (65 vs. 58 years, p<0.001), longer duration of hypertension (160 vs. 48 months, p<0.001), uncontrolled hypertension (59.8 vs. 15.9%, p<0.001), tobacco smoking (17.8 vs. 3.8%, p=0.016), higher systolic blood pressure (133 vs. 124mmHg, p=0.001) and slower heart rate (62 vs. 66bpm, p=0.023) were associated with LVDD. Multivariate model identified uncontrolled hypertension (AdjOR 36.90; 95% CI 7.94-171.58; p<0.001), smoking (AdjOR 6.66; 95% CI 1.63-27.26; p=0.008), eccentric hypertrophy (AdjOR 3.59; 95% CI 0.89-14.39; p=0.072), duration of hypertension (AdjOR 1.03; 95% CI 1.02-1.05; p<0.001) and concentric remodeling (AdjOR 0.19; 95% CI 0.04-0.93; p=0.041) as the more determinant for occurrence of LVDD. The discriminative capacity of the model was AUC=0.95 (95% CI 0.91-0.98).CONCLUSION: The occurrence of LVDD in hypertensive patients was strongly associated to long-lasting, uncontrolled hypertension, tobacco smoking, concentric remodeling and eccentric hypertrophy.

KW - Determinantes de la disfunción diastólica del ventrículo izquierdo

KW - Diastolic dysfunction determinants

KW - Disfunción diastólica del ventrículo izquierdo

KW - Hipertensión arterial

KW - Hypertension

KW - Left ventricular diastolic dysfunction

U2 - 10.1016/j.hipert.2017.12.002

DO - 10.1016/j.hipert.2017.12.002

M3 - Article

VL - 35

SP - 160

EP - 168

JO - Hipertension y Riesgo Vascular

JF - Hipertension y Riesgo Vascular

SN - 1889-1837

IS - 4

ER -