Early Abnormalities of Cardiovascular Structure and Function in Middle-Aged Korean Adults With Prehypertension: The Korean Genome Epidemiology Study

Abstract

BACKGROUND Prehypertension is associated with increased cardiovascular morbidity and mortality. However, there are few population-based studies on the changes of cardiovascular structure and function that characterize prehypertension. The aim of this study was to assess whether prehypertension is associated with abnormalities of cardiovascular structure and function in the general Korean population. METHODS We analyzed the cross-sectional relationships between prehypertension and cardiovascular structure and function in a sample from the Korean Genome Epidemiology Study. A total of 1,671 individuals (54.5% women; mean age: 53 +/- 6 years) without hypertension and diabetes mellitus were enrolled. Cardiovascular structure and function were assessed by conventional echocardiography, tissue Doppler imaging (TDI), carotid ultrasonography, and pulse wave velocity (PWV). RESULTS The left ventricular (LV) mass index was significantly higher in subjects with prehypertension than in those with normotension (41 +/- 8 g/m(2.7) vs. 38 +/- 7 g/m(2.7), P<0.001). LV diastolic parameters, such as the E/A ratio,TDI E-a velocity, and E/E-a ratio, were also impaired in subjects with prehypertension (all P<0.001). Compared with normotension, prehypertension was characterized by a significantly higher common carotid artery intima media thickness and a higher brachial ankle PWV (all P<0.001). These abnormalities of cardiovascular structure and function remained significant after adjustment for covariates. CONCLUSIONS In this population-based cohort, we found that subtle alterations in cardiovascular structure and function were already present at the prehypertensive stage. Whether such subtle alterations convey an increased risk of cardiovascular events and whether the changes are reversible with treatment warrant further study.