The influence of prehypertension, controlled and uncontrolled hypertension on left ventricular diastolic function and structure in the general Korean population.

Although hypertension is a clear risk factor for cardiovascular disease, how prehypertension and controlled hypertension influence left ventricular (LV) diastolic function and structure remain to be elucidated. Thus, this study was intended to investigate the link between LV diastolic dysfunction and structural changes in different categories of hypertension. A cohort of 52 111 Korean adults receiving echocardiograms was enrolled. The study population was stratified into five groups according to the following categories of hypertension and blood pressure (BP): normotensive (<120/80 mm Hg), prehypertensive (120-139/80-89 mm Hg), controlled hypertensive (<140/90 mm Hg), newly recognized hypertensive and uncontrolled hypertensive (⩾140/90 mm Hg). Multivariate logistic regression analyses were used to assess the odds ratios (ORs) for LV hypertrophy (LVH) and increased relative wall thickness (RWT), and the adjusted mean values of diastolic parameters were used to examine differences in LV diastolic function. We found a significant relationship between elevated BP and LVH. In addition, an association was observed with LV remodeling (increased RWT). The ORs of LV hypertrophy, remodeling and adjusted mean values of echocardiographic parameters showed dose-response relationships across the study groups, in the order (from lowest to highest) of normotensive, prehypertensive, controlled hypertension, newly recognized hypertension and uncontrolled hypertension. The full adjusted ORs of increased RWT were 1.65 (95% confidence interval (CI): 1.45-1.87) in prehypertension, 2.02 (95% CI: 1.74-2.34) in controlled hypertension, 2.85 (95% CI: 2.35-3.43) in newly recognized hypertension and 3.31 (95% CI: 2.68-4.07) in uncontrolled hypertension. The present study results suggest the importance of early detection and proper management of hypertension.