Author + information
- Şeyhmus Külahçıoğlu,
- Süleyman Karakoyun,
- Zübeyde Bayram,
- Mustafa Ozan Gürsoy,
- Lütfi Öcal and
- Ruken Bengi Bakal
Prehypertension is defined as a systolic blood pressure (SBP) of 120-139 mmhg or/ and a diastolic blood pressure (DBP) of 80-89 mmhg. Prehypertensive patients have higher risk of developing hypertension in their life time than those with blood pressure <120/80 mmhg. Impaired left ventricular systolic function is associated with poor outcomes in patients with hypertension. In our study, we aimed to show the impact of prehypertension on left ventricular mechanics in prehypertensive patients with preserved ejection fraction using speckle tracking echocardiography (STE).
Between December 2010 and February 2011, 136 patients were enrolled in this study. As measured by outpatient, the patients who had SBP ranging from 120-139 mmhg or/and DBP ranging from 80-89 mmhg constituted the prehypertensive population (group 1) and the patients who had SBP lower than 120 mmhg and DBP lower than 80 mmhg constituted the control population (group 2). The prehypertensive patient group was divided into 2 subgroups: SBP between 130 and 139 mm Hg and/or DBP between 85 and 89 mmHg were defined ‘high normal’, whereas SBP between 120 and 129 mm Hg an/or DBP between 80 and 84 mmHg were defined ‘normal’. Patients who had blood pressure ≥140-90 mmhg, diabetes mellitus, thyroid dysfunction, anemia, chronic obstructive pulmonary disease, renal disorder, structural heart disease and moderate or severe valvular heart disease were excluded from the study. In STE examination, left ventricular strain, peak longitudinal strain were calculated from apical 4 chamber, 2 chamber and long axis images and global strain was calculated from the average of apical 4 chamber, 3 chamber and 2 chamber images.
There were 66 patients (mean age 49.2 ±6, 37 male) in group 1 and 70 patients (mean age 47.6± 6, 36 male) in group 2. There were no differences between groups in terms of age, hyperlipidemia, body mass index, smoking and family history. Left ventricular global longitudinal strain and circumferential strain levels were significantly impaired in group 1 compared to group 2 (14.7±3.3, 22.6±2.3; p<0.001 and 15.3±2.7, 20.7±2.8; p<0.001, respectively) whereas no significant difference was observed between groups in terms of radial strain levels (36.5±2.7, 37.4±3.3; p=0.146). Left ventricular global longitudinal and circumferential strain values were 14.2±3.3 vs 15.1±2.8, respectively in the subgroup with high normal blood pressure and 15.3±3.2 and 15.6±2.7, respectively in the subgroup with normal blood pressure, however there was no significant statistical difference (p:0.162 and p:0.422, respectively).
Left ventricular longitudinal and circumferential strain are impaired in patients with prehypertension, compared to patients with optimal blood pressure.