Prognostic value of left ventricular concentric remodeling in uncomplicated mild hypertension.
BACKGROUND
The prognostic value of left ventricular (LV) concentric remodeling in essential hypertension, and particularly in uncomplicated mild hypertension, is not yet completely clear. We investigated cardiovascular outcome in uncomplicated mild hypertensive patients with normal LV geometry and LV concentric remodeling.


METHODS
The occurrence of fatal and nonfatal cardiovascular events was evaluated in 1088 uncomplicated mild hypertensive patients, 751 with normal LV geometry (LV mass index <125 g/m(2) in men and <110 g/m(2) in women and relative wall thickness <0.45) and 337 with LV concentric remodeling (LV mass index <125 g/m(2) in men and <110 g/m(2) in women and relative wall thickness >/=0.45).


RESULTS
During follow-up (4.74 +/- 2.4 years, range 0.5 to 9.7 years) the event rates per 100 patient-years in subjects with normal LV geometry and LV concentric remodeling were 0.69 and 1.87, respectively. After adjustment for other covariates, Cox regression analysis showed that LV concentric remodeling (LV concentric remodeling versus normal LV geometry, RR 1.78, 95% CI 1.02 to 3.1, P < .05) was an independent predictor of cardiovascular events.


CONCLUSIONS
In a population with uncomplicated mild hypertension, patients with LV concentric remodeling have a worse prognosis than those with normal LV geometry.
Pierdomenico
Sante D
SD
Dipartimento di Medicina e Scienze dell'Invecchiamento, University Gabriele d'Annunzio, Chieti, Italy.
Lapenna
Domenico
D
Bucci
Anna
A
Manente
Bianca M
BM
Cuccurullo
Franco
F
Mezzetti
Andrea
A
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020257:Ventricular Remodeling / Q000502:physiology*