Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension

ABSTRACT This study aimed to investigate the associations between 24‐hour urinary cortisol levels (24 h‐UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypert...

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Main Authors: Gao‐Zhen Cao, Jia‐Yi Huang, Qing‐Shan Lin, Run Wang, Cong Chen, Jian‐Cheng Xiu, Kai‐Hang Yiu
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.14979
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author Gao‐Zhen Cao
Jia‐Yi Huang
Qing‐Shan Lin
Run Wang
Cong Chen
Jian‐Cheng Xiu
Kai‐Hang Yiu
author_facet Gao‐Zhen Cao
Jia‐Yi Huang
Qing‐Shan Lin
Run Wang
Cong Chen
Jian‐Cheng Xiu
Kai‐Hang Yiu
author_sort Gao‐Zhen Cao
collection DOAJ
description ABSTRACT This study aimed to investigate the associations between 24‐hour urinary cortisol levels (24 h‐UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypertension who underwent baseline 24 h‐UFC measurement and echocardiographic evaluation of left ventricular mass (LVM), left ventricular ejection fraction (LVEF), and the E/e′ ratio. Over a mean follow‐up period of 28.54 ± 14.21 months, patients were grouped into tertiles based on baseline 24 h‐UFC levels. Higher baseline 24 h‐UFC levels were significantly associated with greater increases in LVM and E/e′, reflecting adverse LV remodeling and diastolic dysfunction. These associations persisted after adjusting for potential confounders, including age, gender, baseline blood pressure, and their changes during follow‐up. Moreover, patients in the highest 24 h‐UFC tertile showed an increased prevalence of LV hypertrophy, contrasting with a reduction observed in the lower tertiles. These findings underscore the independent role of elevated 24 h‐UFC levels in driving adverse cardiac structural and functional changes in essential hypertension.
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publisher Wiley
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series The Journal of Clinical Hypertension
spelling doaj-art-350c03c63edb463e9fb2d342cdcdbf672025-08-20T03:04:53ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-02-01272n/an/a10.1111/jch.14979Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential HypertensionGao‐Zhen Cao0Jia‐Yi Huang1Qing‐Shan Lin2Run Wang3Cong Chen4Jian‐Cheng Xiu5Kai‐Hang Yiu6The First School of Clinical Medicine Southern Medical University Guangzhou ChinaDivision of Cardiovascular Medicine Cardiac and Vascular Center The University of Hong Kong‐Shenzhen Hospital Shenzhen ChinaDivision of Radiology Department of Medicine The University of Hong Kong‐Shenzhen Hospital Shenzhen ChinaDivision of Cardiovascular Medicine Cardiac and Vascular Center The University of Hong Kong‐Shenzhen Hospital Shenzhen ChinaDivision of Cardiovascular Medicine Cardiac and Vascular Center The University of Hong Kong‐Shenzhen Hospital Shenzhen ChinaThe First School of Clinical Medicine Southern Medical University Guangzhou ChinaDivision of Cardiovascular Medicine Cardiac and Vascular Center The University of Hong Kong‐Shenzhen Hospital Shenzhen ChinaABSTRACT This study aimed to investigate the associations between 24‐hour urinary cortisol levels (24 h‐UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypertension who underwent baseline 24 h‐UFC measurement and echocardiographic evaluation of left ventricular mass (LVM), left ventricular ejection fraction (LVEF), and the E/e′ ratio. Over a mean follow‐up period of 28.54 ± 14.21 months, patients were grouped into tertiles based on baseline 24 h‐UFC levels. Higher baseline 24 h‐UFC levels were significantly associated with greater increases in LVM and E/e′, reflecting adverse LV remodeling and diastolic dysfunction. These associations persisted after adjusting for potential confounders, including age, gender, baseline blood pressure, and their changes during follow‐up. Moreover, patients in the highest 24 h‐UFC tertile showed an increased prevalence of LV hypertrophy, contrasting with a reduction observed in the lower tertiles. These findings underscore the independent role of elevated 24 h‐UFC levels in driving adverse cardiac structural and functional changes in essential hypertension.https://doi.org/10.1111/jch.14979essential hypertensionleft ventricular functionleft ventricular structurelongitudinal changesurinary free cortisol
spellingShingle Gao‐Zhen Cao
Jia‐Yi Huang
Qing‐Shan Lin
Run Wang
Cong Chen
Jian‐Cheng Xiu
Kai‐Hang Yiu
Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
The Journal of Clinical Hypertension
essential hypertension
left ventricular function
left ventricular structure
longitudinal changes
urinary free cortisol
title Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
title_full Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
title_fullStr Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
title_full_unstemmed Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
title_short Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
title_sort association between longitudinal changes in left ventricular structure and function and 24 hour urinary free cortisol in essential hypertension
topic essential hypertension
left ventricular function
left ventricular structure
longitudinal changes
urinary free cortisol
url https://doi.org/10.1111/jch.14979
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