Association of blood pressure and left ventricular mass with subclinical coronary atherosclerosis

Background Left ventricular (LV) mass is closely associated with atherosclerotic heart disease, but the mechanisms are not well defined. This study aimed to evaluate the risk factors associated with LV mass and subclinical coronary atherosclerosis, in an Asian population free of baseline cardiovascu...

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Main Authors: Weiting Huang, Calvin Chin, Rehena Sultana, Chirk Jenn Ng, Jonathan Jiunn Liang Yap, Enver De Wei Loh, Swee Yaw Tan, Siew Ching Kong, Khung K Yeo
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/12/1/e002791.full
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Summary:Background Left ventricular (LV) mass is closely associated with atherosclerotic heart disease, but the mechanisms are not well defined. This study aimed to evaluate the risk factors associated with LV mass and subclinical coronary atherosclerosis, in an Asian population free of baseline cardiovascular disease.Methods The SingHEART study is a population-based cohort in which individuals underwent ambulatory blood pressure (BP) monitoring, cardiac MRI to measure indexed LV mass index (LVMI) and coronary artery calcium (CAC) scoring. Individuals were stratified based on LVMI and the presence of CAC, and intergroup differences in risk factors were analysed. Logistic regression models were used to assess the interaction of BP and LVMI on prevalent CAC.Results The study included 880 subjects (mean age 45.8±11.7 years, 51.4% women). Individuals with high LVMI had higher BP than those with normal LVMI. Across all LVMI groups, higher BP was associated with the presence of CAC. Compared with individuals with normotensive BP and normal LVMI, those with normotensive BP and high LVMI had no increased risk of prevalent CAC (p=0.530); however, risk was progressively higher in those with hypertensive BP and normal LVMI (risk ratio (RR) 1.47, 95% CI 1.13 to 1.91), or hypertensive BP and high LVMI (RR 1.72, 95% CI 1.26 to 2.36).Conclusions In this healthy asymptomatic population, hypertension was the strongest risk factor for high LVMI and prevalent CAC. LV hypertrophy was a risk modifier, and its prognostic significance in adults without hypertension requires further study.
ISSN:2053-3624