title: Implications of persistent prehypertension for ageing-related changes in left ventricular geometry and function: the MONICA/KORA Augsburg study.
abstract: BACKGROUND
  It is unclear whether persistent prehypertension causes structural or functional alterations of the heart.
  
  
  METHODS
  We examined echocardiographic data of 1005 adults from a population-based survey at baseline in 1994/1995 and at follow-up in 2004/2005. We compared individuals who had either persistently normal (<120 mmHg systolic and <80 mmHg diastolic, n = 142) or prehypertensive blood pressure (120-139 mmHg or 80-89 mmHg, n = 119) at both examinations using multivariate regression modeling.
  
  
  RESULTS
  Over 10 years, left ventricular end-diastolic diameters were stable and did not differ between the two groups. However, the prehypertensive blood pressure group displayed more pronounced ageing-related increases of left ventricular wall thickness (+4.7 versus +11.9%, P < 0.001) and left ventricular mass (+8.6 versus +15.7%, P = 0.006). Prehypertension was associated with a raised incidence of left ventricular concentric remodeling (adjusted odds ratio 10.7, 95% confidence interval 2.82-40.4) and left ventricular hypertrophy (adjusted odds ratio 5.33, 1.58-17.9). The ratio of early and late diastolic peak transmitral flow velocities (E/A) decreased by 7.7% in the normal blood pressure versus 15.7% in the prehypertensive blood pressure group (P = 0.003) and at follow-up the ratio of early diastolic peak transmitral flow and early diastolic peak myocardial relaxation velocities (E/EM) was higher (9.1 versus 8.5, P = 0.031) and left atrial size was larger (36.5 versus 35.3 mm, P = 0.024) in the prehypertensive blood pressure group. Finally, the adjusted odds ratio for incident diastolic dysfunction was 2.52 (1.01-6.31) for the prehypertensive blood pressure group.
  
  
  CONCLUSIONS
  Persistent prehypertension accelerates the development of hypertrophy and diastolic dysfunction of the heart.
authors.affiliation: Medical Clinic II, University of Lübeck Medical School, Lübeck, Germany.
authors.forename: Marcello Ricardo Paulista
authors.initials: MR
authors.lastname: Markus
authors.forename: Jan
authors.initials: J
authors.lastname: Stritzke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.forename: Björn
authors.initials: B
authors.lastname: Mayer
authors.forename: Andreas
authors.initials: A
authors.lastname: Luchner
authors.forename: Angela
authors.initials: A
authors.lastname: Döring
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
mesh_terms: D000328:Adult; D000375:Aging; D003971:Diastole / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D016017:Odds Ratio