Early Abnormalities of Cardiovascular Structure and Function in Middle-Aged Korean Adults With Prehypertension: The Korean Genome Epidemiology Study

• Published in: American journal of hypertension Vol. 24; no. 2; pp. 218 - 224
• Main Authors: Kim, Seong Hwan, Cho, Goo-Yeong, Baik, Inkyung, Lim, Sang Yup, Choi, Cheol Ung, Lim, Hong Euy, Kim, Eung Ju, Park, Chang Gyu, Park, Juri, Kim, Jinyoung, Shin, Chol
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01-02-2011; Nature Publishing Group
• Subjects: Ankle Brachial Index; Arterial hypertension. Arterial hypotension; Asian Continental Ancestry Group - genetics; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - ethnology; Cardiovascular Diseases - genetics; Cardiovascular Diseases - physiopathology; Carotid Arteries - diagnostic imaging; Carotid Arteries - physiopathology; Chi-Square Distribution; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Cross-Sectional Studies; Echocardiography, Doppler; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Medical sciences; Middle Aged; Prehypertension - diagnostic imaging; Prehypertension - ethnology; Prehypertension - genetics; Prehypertension - physiopathology; Prospective Studies; Pulsatile Flow; Republic of Korea - epidemiology; Risk Assessment; Risk Factors; Ventricular Function, Left; blood pressure; diastolic function; prehypertension; carotid intima-media thickness; hypertension; left ventricular mass; tissue Doppler imaging; arterial pulse wave velocity; Hypertension; Tissue doppler; Cardiovascular disease; Arterial pulse; carotid intimamedia thickness; Epidemiology; Left ventricle; Carotid; Arterial pressure; Blood pressure; Genome
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2010.213

Background
Prehypertension is associated with increased cardiovascular morbidity and mortality. However, there are few population-based studies on the changes of cardiovascular structure and function that characterize prehypertension. The aim of this study was to assess whether prehypertension is associated with abnormalities of cardiovascular structure and function in the general Korean population.
Methods
We analyzed the cross-sectional relationships between prehypertension and cardiovascular structure and function in a sample from the Korean Genome Epidemiology Study. A total of 1,671 individuals (54.5% women; mean age: 53 ± 6 years) without hypertension and diabetes mellitus were enrolled. Cardiovascular structure and function were assessed by conventional echocardiography, tissue Doppler imaging (TDI), carotid ultrasonography, and pulse wave velocity (PWV).
Results
The left ventricular (LV) mass index was significantly higher in subjects with prehypertension than in those with normotension (41 ± 8 g/m2.7 vs. 38 ± 7 g/m2.7, P < 0.001). LV diastolic parameters, such as the E/A ratio, TDI Ea velocity, and E/Ea ratio, were also impaired in subjects with prehypertension (all P< 0.001). Compared with normotension, prehypertension was characterized by a significantly higher common carotid artery intima-media thickness and a higher brachial-ankle PWV (all P < 0.001). These abnormalities of cardiovascular structure and function remained significant after adjustment for covariates.
Conclusions
In this population-based cohort, we found that subtle alterations in cardiovascular structure and function were already present at the prehypertensive stage. Whether such subtle alterations convey an increased risk of cardiovascular events and whether the changes are reversible with treatment warrant further study.
American Journal of Hypertension, advance online publication 30 September 2010;doi:10.1038/ajh.2010.213