HypertensionCohort study
Cumulative blood pressure exposure and global and regional cardiac structure and function: the Multi-Ethnic Study of Atherosclerosis (MESA) study
- Cohort study
Authors' conclusion
Higher cumulative BP was associated with worse global and regional cardiac structure/function and myocardial scar, independent of a single BP at the time of imaging, and was still observed to some extent in non-hypertensive individuals who consistently maintained BP levels below the hypertension threshold.
Study context
- Population
- Adults from MESA who underwent cardiac magnetic resonance (CMR) at Year 10 (Exam 5, 2010–12)
- Participants
- 3,015 adults
- Exposure
- Higher vs lower cumulative blood pressure (BP) exposure
- Outcome
- LV structure, global/regional myocardial function (tagged CMR), interstitial fibrosis (T1 mapping) and myocardial scar (late gadolinium enhancement)
Main finding
Cumulative SBP, independent of current SBP
Odds ratio
1.36
95% CI 1.02–1.82
Per SD, as printed
As reported in the abstract
- Increased left ventricular (LV) mass index per SD
- 1.93 g/m²
- Worse global/regional circumferential strain (lower absolute values per SD)
- 0.24-0.38%
- Cumulative diastolic BP (DBP) associated with circumferential strain, nearly J-shaped after adjusting for current DBP
- all P < 0.05
Observational data: associations, not effects.
Further findings
Myocardial scar, non-hypertensive individuals (BP consistently below hypertension threshold) (subgroup)
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| cumulative SBP | 1.53 (0.82–2.87) | P = 0.19 | |
| 0.20.5125Odds ratio (log scale) |
Myocardial scar, non-hypertensive individuals (BP consistently below hypertension threshold) (subgroup)
- Cumulative systolic BP (SBP) remained significantly associated with LV mass index and strain but not myocardial scar
Circumferential strain, cumulative DBP
- Cumulative DBP associated with circumferential strain, nearly J-shaped relationships after adjusting for current DBP
- all P < 0.05
Original publication
Summarised from the published abstract; every number is checked against it