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Left ventricular mass independently associates with masked hypertension in young healthy adults: the African-PREDICT study

Sekoba, Nare P.a; Kruger, Ruana,b; Labuschagne, Pietera; Schutte, Aletta E.a,b

doi: 10.1097/HJH.0000000000001740

Objective: Masked hypertension is reportedly common in young adults. However, it is unknown if these masked hypertensive individuals already present with organ damage. We determined whether a relationship exists between left ventricular structure and function, and masked hypertension in young healthy adults.

Methods: In this cross-sectional study, we included 774 black and white men and women (aged 20–30 years) who had successful ambulatory blood pressure monitoring readings (>70% valid readings) and valid echocardiography done.

Results: We found that 16.4% had masked hypertension (60.6% whites; 67.7% men). When performing multivariable-adjusted logistic regression, we found masked hypertensive patients to have higher odds to present with increased left ventricular mass index (odds ratio 1.67, P = 0.031) compared to normotensive individuals. In multivariable-adjusted linear regression analyses, left ventricular mass index positively and independently associated with masked hypertension [adjusted R 2 = 0.193, β = 0.08 (0.01; 0.16), P = 0.046]. However, we found no independent link between echocardiographic measures of left ventricular function and masked hypertension.

Conclusion: This study highlights the importance of the early detection of masked hypertension as young apparently healthy adults already show an increased left ventricular mass index, thereby indicating increased risk for future cardiovascular disease.

aHypertension in Africa Research Team, Faculty of Health Sciences

bMRC Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa

Correspondence to Professor Aletta E. Schutte, Hypertension in Africa Research Team, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa Tel: +27 18 299 2444; fax: +27 18 285 2432; e-mail:

Abbreviations: ABPM, ambulatory blood pressure monitoring; AEE, activity energy expenditure; BP, blood pressure; CKD, chronic kidney disease; CVD, cardiovascular disease; E/A, ratio of mitral peak velocity of early and late diastolic filling; E/é, ratio of mitral peak velocity of early filling to early diastolic mitral annular; eGFR, estimated glomerular filtrate rate; GGT, у-glutamyl transferase; HDL-c, high-density lipoprotein cholesterol; LA/Ao, left atrial to aortic root ratio; LDL-c, low-density lipoprotein cholesterol; LVMI, left ventricular mass index; MHT, masked hypertension; RWT, relative wall thickness

Received 1 December, 2017

Revised 7 February, 2018

Accepted 1 March, 2018

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