title: Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients: The Campania Salute Network.
abstract: There is little information on left ventricular (LV) hypertrophy (LVH) development during antihypertensive treatment. We evaluate incident LVH in a treated hypertensive cohort, the Campania Salute Network registry. We analyzed prospectively 4290 hypertensives (aged 50.3±11.1 years, 40% women) with at least 1-year follow-up, without LVH at baseline. Incident LVH was defined as the first detection of echocardiographic LV mass index ≥47 in women or ≥50 g/m2.7in men. During a median 48-month follow-up, 915 patients (21.3%) developed LVH. They were older, more frequently women, and obese (P<0.0001), with initial higher fasting glucose, diastolic and systolic blood pressure, LV mass index, lower heart rate and glomerular filtration rate, longer hypertension history and follow-up, and higher average systolic blood pressure during follow-up (all P<0.05), despite a more frequent treatment with Ca++-channel blockers and diuretics (both P<0.02). At multivariable Cox regression, incident LVH was independently associated with older age, female sex, obesity, higher average systolic blood pressure during follow-up, and initial greater LV mass index (all P<0.02). By categorizing patients according to obesity and sex, obesity independently increased the risk for incident LVH in both sexes (obese versus nonobese men: hazard ratio, 1.34; confidence interval, 1.05-1.72; P=0.019; and obese versus nonobese women: hazard ratio, 1.34; confidence interval, 1.08-1.66; P=0.007). Despite more aggressive antihypertensive therapy, 21% of hypertensive patients develop clear-cut LVH. After adjusting for confounders, risk of incident LVH is particular relevant among women and is further increased by the presence of obesity.
  
  
  
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT02211365.
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Maria-Angela
authors.initials: MA
authors.lastname: Losi
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Eugenio
authors.initials: E
authors.lastname: Stabile
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Mai Tone
authors.initials: MT
authors.lastname: Lönnebakken
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Grazia
authors.initials: G
authors.lastname: Canciello
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.). trimarco@unina.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.affiliation: From the Hypertension Research Center (R.I., M.-A.L., E.S., M.T.L., G.C., G.E., E.B., N.D.L., B.T., G.d.S.), Department of Translational Medical Sciences (R.I., G.C., N.D.L., G.d.S.), and Department of Advanced Biomedical Sciences (M.-A.L., E.S., G.E., E.B., B.T.), Federico II University, Naples, Italy; and Department of Clinical Science, University of Bergen, Norway (M.T.L.).
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; echocardiography; female; hypertension; obesity