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Myocardial damage may predict hypertension development in normotensive individuals

07 Feb 2018

Individuals with normal blood pressure (BP) levels who present with subclinical myocardial damage are highly likely to develop subsequent hypertension, a recent study suggests.

Researchers examined 524 normotensive individuals (mean age 58 years; 53 percent female) without prior cardiovascular diseases at baseline. They evaluated ongoing myocardial damage by measuring the biomarker heart-type fatty acid binding protein (H-FABP) and assessed longitudinal changes in BP over a median follow-up period of 6.2 years.

There were 177 individuals (34 percent) who developed hypertension during the follow-up. On multivariate Cox proportional hazard analysis controlled for potential confounders such as age and baseline BP, presence of myocardial damage was significantly associated with an increased risk of developing hypertension (hazard ratio, 1.80; 95 percent CI, 1.26–2.54; p=0.0014).

Moreover, the relative risk of incident hypertension associated with myocardial damage was higher among younger individuals and for the lower BP category.

Researchers enumerated several possible reasons why preceding myocardial damage predicts future development of hypertension. First, the presence of myocardial damage in individuals with normal BP may originate from the underlying central haemodynamic stress, which is undetectable by brachial BP. Second, myocardial damage reflects the presence of masked hypertension at baseline in apparently normotensive individuals, and the said hypertension may become sustained during follow-up.

The present data suggest that individuals with normal blood pressure but with myocardial damage may be required further screening to detect hypertension, which can in turn reduce future healthcare costs by preventing cardiovascular diseases, researchers said.

“Therefore, further studies are required to determine in whom myocardial damage should be assessed to maximize the cost-effectiveness,” they added.

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Most Read Articles
2 days ago
The appropriate cutoff value in predicting combined cardiovascular outcomes in patients with type 2 diabetes (T2D) is 125 mm Hg for home morning systolic blood pressure (MSBP), suggests a new study.
06 Apr 2018

Female patients with coronary artery disease (CAD) have greater regression of coronary atherosclerosis than male patients despite a lower plaque burden at baseline, data from the GLAGOV trial have shown.

26 Apr 2018
Transcatheter aortic valve replacement (TAVR) in severe symptomatic aortic stenosis (AS) patients is superior to conventional surgical aortic valve replacement (SAVR) in terms of reducing life-threatening bleeding, new-onset atrial fibrillation and acute kidney injury, a recent meta-analysis has found.
Pearl Toh, Yesterday
Whether the 2017 ACC/AHA* blood pressure (BP) guidelines should be adopted in Asian countries was the topic of a much-anticipated discussion here at the Asian Pacific Society of Cardiology (APSC) Congress 2018 in Taiwan last week.