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P10.3 Arterial Stiffness is a Better Predictor of Left Ventricular Hypertrophy than the Framingham Risk Score and Central Hemodynamics: Insights From 1,141 Never-Treated Hypertensives

Abstract

Objective

Left ventricular hypertrophy (LVH) heralds target organ damage and calls for aggressive therapeutic approaches. We investigated the predictive ability of arterial stiffness, central hemodynamic indices and the Framingham Risk Score (FRS) for detecting LVH.

Design and Method

1,141 newly diagnosed, never-treated hypertensives were recruited. cfPWV, aortic BPs and AIx were measured. Left ventricular mass index (LVMI) was calculated according to the Devereux formula. LVH was defined as LVMI >95 g/m2 (women) and >115 g/m2 (men). The 10-year risk for CVD was calculated using the FRS.

Results

The cohort was young (age: 53±12 years), with mild-moderate hypertension (BP: 151±18/90±11 mmHg). LVH was detected in 43% of patients and 10-year CVD risk was 16.1 ±9.7%. LVMI had a stronger correlation with cfPWV (r=0.39, p<0.001) compared to aortic SBP (r=0.33, p<0.001), pulse pressure (r=0.306, p<0.001) and AIx (r=0.121, p<0.001). After adjusting for diabetes mellitus presence, eGFR, aortic SBP, cholesterol and 10-year CVD risk, cfPWV remained an independent predictor of LVMI (R2=0.243, B=1.60, p<0.001). In ROC analysis, cfPWV emerged as a better predictor of LVH (AUC: 0.735, p<0.001) compared to the FRS (AUC: 0.727, p<0.001), aortic SBP (AUC: 0.687, p<0.001), aortic pulse pressure (AUC: 0.705, p<0.001) and AIx (AUC: 0.649, p<0.001).

Conclusion

In newly diagnosed, never-treated hypertensives, cfPWV is associated with LVMI and is a better predictor of LVH than the FRS, aortic BPs and AIx. High cfPWV values signify target organ damage, which extends beyond large artery stiffness and herald LVH. This has implications for risk stratification and choice of antihypertensive therapy.

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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Xaplanteris, P., Vlachopoulos, C., Terentes, D. et al. P10.3 Arterial Stiffness is a Better Predictor of Left Ventricular Hypertrophy than the Framingham Risk Score and Central Hemodynamics: Insights From 1,141 Never-Treated Hypertensives. Artery Res 8, 158 (2014). https://doi.org/10.1016/j.artres.2014.09.206

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.206