Prevalence of Doppler‑Derived Left Ventricular Diastolic Dysfunction Among Newly Diagnosed Hypertensive Patients

Abstract

Background: The initial sign of hypertensive heart disease (HHD) is left ventricular diastolic dysfunction (LVDD), which is caused by  remodeling of the left ventricle and left atrium, resulting in impaired relaxation of the left ventricle. LVDD is also partly due to left  ventricular hypertrophy (LVH). If left untreated, LVDD can progress to diastolic heart failure and systolic heart failure. In Western  countries, the prevalence of LVDD in long-term hypertensive patients ranges from 40.3% to 60%, but it is more common among  hypertensive Nigerians. Since systemic hypertension can be asymptomatic in the early stages, it is important to evaluate LVDD early and  control blood pressure to slow down its progression. 

Aims and Objectives: The study aims to highlight the prevalence of LVDD and to  determine the stages of LVDD among newly diagnosed hypertensive patients at the University of Maiduguri Teaching Hospital (UMTH).   

Method: The study design is a hospital-based, cross-sectional, observational study. The study population consists of 352 consecutive  treatment Naïve hypertensive adult patients aged 18 years and above who presented to the Cardiology Clinic of UMTH from June 2019 to  June 2021. The study used the diagnostic criteria for LVDD and LVH which were based on the American Society of Echocardiography and  the European Association of Cardiovascular Imaging. 

Results: A total of 352 newly diagnosed hypertensive patients were recruited, with a  mean age of 50.9 ± 11.8 years, and 54.3% were female. The majority of patients (63.6%) were overweight or obese, with a mean body  mass index (BMI) of 28.5 ± 4.6 kg/m² . The mean systolic blood pressure (SBP) was 155.7 ± 16.9 mmHg, and the mean diastolic blood  pressure (DBP) was 92.8 ± 10.8 mmHg. LVDD was found in 58.5% of the patients, with stage 1 LVDD being the most common (42.6%), followed by stage 2 LVDD (15.9%). The prevalence of LVDD was significantly higher in females compared to males. Patients with LVDD  were significantly older and had higher BMI, higher systolic and DBP, higher pulse pressure, higher LAVI, and higher LVMI compared to  those without LVDD (P < 0.05). 

Conclusion: LVDD is highly prevalent among newly diagnosed hypertensive patients, with stage 1 being the most common. Female gender, older age, higher BMI, higher blood pressure, higher LAVI, and higher LVMI were significant  predictors of LVDD. Early detection and appropriate management of LVDD may help to prevent adverse cardiovascular outcomes in  hypertensive patients.