Hypertension-mediated Cardiac Damage Among Romanian Adult Hypertensive Patients: A Post-hoc Echocardiographic Analysis of the SEPHAR IV Epidemiological Survey

Abstract

Abstract Background: Data regarding cardiac damage in Romanian hypertensive adults are scarce. Our aim was to assess hypertension-mediated subclinical and clinical cardiac damage using a post-hoc echocardiographic analysis of a national epidemiological survey. Methods: A representative sample of 1477 subjects was included in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) survey. We retrieved echocardiographic data for 976 subjects, who formed our study group. Cardiac damage included left ventricular (LV) hypertrophy (defined as an LV mass > 95 g/m2 in females and > 115 g/m2 in males), coronary artery disease (CAD), and LV diastolic and systolic dysfunction. Results: Hypertension prevalence was 46.0% in SEPHAR IV and 45.3% in our study subgroup. Hypertensives had a higher prevalence of LV hypertrophy, CAD, diastolic dysfunction (p<0.001 for all) and systolic dysfunction (p=0.03) than normotensives. Age (OR=1.05;95% CI,1.03–1.08;p<0.001), female sex (OR=2.07;95% CI,1.24–3.45;p=0.006), and systolic blood pressure (OR=1.02;95% CI,1.01−1.04;p=0.026) were independent predictors of LVH in hypertensives. Age was a predictor of diastolic dysfunction (OR=1.04;95% CI,1.02−1.06;p<0.001), and female sex was a protective factor against systolic dysfunction (OR=0.26;95% CI,0.10–0.71;p=0.009). Age (OR=1.05;95% CI,1.02−1.07;p<0.001) and dyslipidemia (OR=1.89;95% CI,1.20–3.00;p=0.007) were independent determinants of CAD in hypertensives. Conclusion: The prevalence of cardiac damage in Romanian hypertensives is high. Both non-modifiable risk factors (such as age and gender) and modifiable (such as dyslipidemia and systolic blood pressure) risk factors are independent predictors of cardiac damage in hypertensives.