Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients

Background: Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderl...

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Main Authors: Chowdhury, E., Jennings, G., Dewar, E., Wing, L., Reid, Christopher
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/56642
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author Chowdhury, E.
Jennings, G.
Dewar, E.
Wing, L.
Reid, Christopher
author_facet Chowdhury, E.
Jennings, G.
Dewar, E.
Wing, L.
Reid, Christopher
author_sort Chowdhury, E.
building Curtin Institutional Repository
collection Online Access
description Background: Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderly hypertensive patients without heart failure. Methods: Data from LVH substudy of the Second Australian National Blood Pressure trial were used. Echocardiograms were performed at entry into the study. Cardiovascular outcomes were identified over short term (median 4.2 years) and long term (median 10.9 years). LVH was defined using threshold values of LV mass (LVM) indexed to either body surface area (BSA) or height2.7 : >115/95g/m 2 (LVH-BSA 115/95) or ≥49/45g/m 2.7 (LVH-ht 49/45) in males/females, respectively, and ≥125g/m 2 (LVH-BSA125) or ≥51g/m 2.7 (LVH-ht 51) for both sexes. Results: In the 666 participants aged ≥65 years in this analysis, LVH prevalence at baseline was 33%–70% depending on definition; and after adjusting for potential risk factors, only LVH-BSA 115/95 predicted both short- and long-term cardiovascular outcomes. Participants having LVH-BSA 115/95(69%) at baseline had twice the risk of having any first cardiovascular event over the short term (hazard ratio, 95% confidence interval: 2.00, 1.12–3.57, P = 0.02) and any fatal cardiovascular events (2.11, 1.21–3.68, P = 0.01) over the longer term. Among other echocardiographic parameters, LVM and LVM indexed to either BSA or height 2.7 predicted cardiovascular events over both short and longer term. Conclusions: In elderly treated hypertensive patients without heart failure, determining LVH by echocardiography is highly dependent on the methodology adopted. LV H-BSA 115/95 is a reliable predictor of future cardiovascular outcomes in the elderly.
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spelling curtin-20.500.11937-566422018-01-05T07:12:55Z Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients Chowdhury, E. Jennings, G. Dewar, E. Wing, L. Reid, Christopher Background: Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderly hypertensive patients without heart failure. Methods: Data from LVH substudy of the Second Australian National Blood Pressure trial were used. Echocardiograms were performed at entry into the study. Cardiovascular outcomes were identified over short term (median 4.2 years) and long term (median 10.9 years). LVH was defined using threshold values of LV mass (LVM) indexed to either body surface area (BSA) or height2.7 : >115/95g/m 2 (LVH-BSA 115/95) or ≥49/45g/m 2.7 (LVH-ht 49/45) in males/females, respectively, and ≥125g/m 2 (LVH-BSA125) or ≥51g/m 2.7 (LVH-ht 51) for both sexes. Results: In the 666 participants aged ≥65 years in this analysis, LVH prevalence at baseline was 33%–70% depending on definition; and after adjusting for potential risk factors, only LVH-BSA 115/95 predicted both short- and long-term cardiovascular outcomes. Participants having LVH-BSA 115/95(69%) at baseline had twice the risk of having any first cardiovascular event over the short term (hazard ratio, 95% confidence interval: 2.00, 1.12–3.57, P = 0.02) and any fatal cardiovascular events (2.11, 1.21–3.68, P = 0.01) over the longer term. Among other echocardiographic parameters, LVM and LVM indexed to either BSA or height 2.7 predicted cardiovascular events over both short and longer term. Conclusions: In elderly treated hypertensive patients without heart failure, determining LVH by echocardiography is highly dependent on the methodology adopted. LV H-BSA 115/95 is a reliable predictor of future cardiovascular outcomes in the elderly. 2016 Journal Article http://hdl.handle.net/20.500.11937/56642 10.1093/ajh/hpw035 unknown
spellingShingle Chowdhury, E.
Jennings, G.
Dewar, E.
Wing, L.
Reid, Christopher
Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title_full Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title_fullStr Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title_full_unstemmed Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title_short Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
title_sort predictive performance of echocardiographic parameters for cardiovascular events among elderly treated hypertensive patients
url http://hdl.handle.net/20.500.11937/56642