Prevalence of Left Ventricular Hypertrophy and Geometric Variations in Asymptomatic Hypertensive Adult Patients

International Journal of Medicine and Medical Sciences | Vol. 14, No. 3, March 2024 | pp. 17–24

DOI: 10.46882/2024/IJMMS/140017

Original Research Article

Prevalence of Left Ventricular Hypertrophy and Geometric Variations in Asymptomatic Hypertensive Adult Patients

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Left ventricular hypertrophy (LVH) is a strong independent predictor of adverse cardiovascular events in essential hypertension, often remaining asymptomatic during its early stages. This cross-sectional echocardiographic study evaluated the prevalence of LVH and specific patterns of left ventricular (LV) geometric remodeling among asymptomatic hypertensive adult patients. We evaluated 160 adults managed for essential hypertension without clinical history of heart failure or coronary disease. M-mode and two-dimensional echocardiography quantified LV mass index (LVMI) and relative wall thickness (RWT). LV geometry was classified into four groups: normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. The mean duration of hypertension was 5.4 ± 2.8 years, and the mean blood pressure was 148.4 ± 11.5 / 94.2 ± 6.8 mmHg. The overall prevalence of echocardiographic LVH was found to be 44.3% (71/160). Geometric distribution analysis revealed that concentric hypertrophy was the most common abnormal pattern (22.5%), followed by eccentric hypertrophy (13.8%) and concentric remodeling (11.9%), leaving 51.8% with normal geometry. Multivariate logistic regression modeling demonstrated that poor blood pressure control (systolic BP ≥ 140 mmHg) (OR = 3.6, 95% CI = 1.8–7.2, p < 0.001) and concurrent obesity with a BMI ≥ 30 kg/m² (OR = 2.8, p < 0.01) were independent predictors of concentric hypertrophy. A high burden of abnormal LV geometry exists among asymptomatic hypertensive patients. Early echocardiographic screenings are important to identify high-risk geometric patterns and guide appropriate antihypertensive drug choices to promote hypertrophy regression.

Keywords: Essential Hypertension, Left Ventricular Hypertrophy, Echocardiography, Concentric Hypertrophy, Relative Wall Thickness, Cardiovascular Risk

Manuscript Timeline: Received: December 02, 2023; Revised: January 14, 2024; Accepted: February 10, 2024; Published: March 14, 2024.

Citation: Okafor CO, Hassan AJ, Appiah SK. Prevalence of Left Ventricular Hypertrophy and Geometric Variations in Asymptomatic Hypertensive Adult Patients. International Journal of Medicine and Medical Sciences, 2024, 14(3): 17–24. DOI: 10.46882/2024/IJMMS/140017

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