超重人群中，并发高血压与左心室几何结构异常和收缩期心肌功能降低有关：与脂肪相关的心血管功能障碍研究。

Concomitant hypertension is associated with abnormal left ventricular geometry and lower systolic myocardial function in overweight participants: the FAT associated CardiOvasculaR dysfunction study.

机构信息

Department of Clinical Science, University of Bergen.

Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

出版信息

J Hypertens. 2020 Jun;38(6):1158-1164. doi: 10.1097/HJH.0000000000002397.

DOI:10.1097/HJH.0000000000002397

PMID:32371806

Abstract

OBJECTIVE

We studied the impact of concomitant hypertension on left ventricular (LV) systolic myocardial function and geometry in apparently healthy women and men with increased BMI.

MATERIAL AND METHODS

We performed a cross-sectional analysis of 535 participants (59% women) with BMI greater than 27 kg/m without known cardiovascular disease enrolled in the FAT associated CardiOvasculaR dysfunction (FATCOR) study. Hypertension was defined as use of antihypertensive treatment or elevated 24-h ambulatory blood pressure. Abnormal LV geometry was identified as increased relative wall thickness and/or LV mass index. Systolic myocardial function was assessed by midwall shortening (MWS) and speckle tracking peak global longitudinal strain (GLS).

RESULTS

Hypertensive participants were older (49 vs. 46 years), had higher BMI and waist circumference, higher prevalences of diabetes and abnormal LV geometry (29 vs. 16%), and lower GLS (-19 vs. -20%) and MWS (16.3 vs. 17.1%) compared with normotensive participants (all P < 0.01). In multivariable linear regression analyses, hypertension was associated with lower GLS (β=0.11, P = 0.035) and lower MWS (β=0.09, P = 0.029) independent of sex, diabetes, LV hypertrophy, ejection fraction, and waist circumference. Hypertension was also associated with presence of abnormal LV geometry [odds ratio 1.74 (95% confidence interval 1.04-2.89), P = 0.035) independent of the same confounders. When replacing waist circumference with BMI in the models, hypertension retained its association with lower myocardial function, whereas the association with abnormal LV geometry was attenuated.

CONCLUSION

In participants with increased BMI without known clinical cardiovascular disease, concomitant hypertension was associated with lower systolic myocardial function and more abnormal LV geometry.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov NCT02805478.

摘要

目的

我们研究了合并高血压对超重（BMI＞27kg/m²）的健康女性和男性左心室（LV）收缩心肌功能和几何结构的影响。

材料与方法

我们对 535 名参与者（59%为女性）进行了横断面分析，这些参与者均患有 BMI 大于 27kg/m²但无已知心血管疾病的 FAT 相关心血管功能障碍（FATCOR）研究。高血压定义为使用降压药物或 24 小时动态血压升高。异常 LV 几何结构定义为相对壁厚度增加和/或 LV 质量指数增加。通过中层缩短率（MWS）和斑点跟踪峰值整体纵向应变（GLS）评估收缩心肌功能。

结果

与正常血压组相比，高血压组的参与者年龄更大（49 岁比 46 岁）、BMI 和腰围更高、糖尿病和异常 LV 几何结构的患病率更高（29%比 16%）、GLS 更低（-19%比-20%）、MWS 更低（16.3%比 17.1%）（均 P＜0.01）。多变量线性回归分析显示，高血压与 GLS 降低（β=0.11，P=0.035）和 MWS 降低（β=0.09，P=0.029）独立相关，且不受性别、糖尿病、LV 肥厚、射血分数和腰围的影响。高血压也与异常 LV 几何结构的存在相关[比值比 1.74（95%置信区间 1.04-2.89），P=0.035]，独立于上述相同的混杂因素。在模型中用 BMI 代替腰围时，高血压仍然与心肌功能降低相关，而与异常 LV 几何结构的相关性减弱。