Home BP control status mediates link between CV risk, LVH

The morning home blood pressure (BP) control status seems to influence the association between left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) risk, suggests a study.

Some 1,823 participants (mean age 65.1 years, 48.6 percent men, 82 percent on antihypertensive medications) of the Japan Morning Surge-Home BP Study underwent home BP monitoring in the morning and evening for 14 days and echocardiography at baseline.

Controlled home BP was defined as morning systolic BP <135 mm Hg and morning diastolic BP <85 mm Hg. LVH was characterized by LV mass index >115 g/m² in men and >95 g/m² in women.

Of the participants, 1,112 (61 percent) had uncontrolled BP, and 662 (36.3 percent) had LVH (233 men, 429 women).

A total of 140 total CVD events occurred over a median follow-up of 6.8 years. Participants with LVH in the uncontrolled BP group (n=440) had higher incidence rates of total CVD events than those without LVH, but this was not the case in the controlled BP group.

In Cox models, LVH appeared to increase the risk of total CVD events in the uncontrolled BP group (adjusted hazard ratio [aHR], 1.80, 95 percent confidence interval [CI], 1.17–2.75). Again, this was not the case in the controlled BP group (aHR, 1.32, 95 percent CI, 0.70–2.50).

“The assessment of LVH is important to optimize risk stratification of CVD in clinical practice, especially in participants with uncontrolled home BP,” the investigators said.