¹Dipartimento di Medicina e Scienze dell'Invecchiamento, University "Gabriele d'Annunzio," Chieti, Italy

Correspondence: Dr. Sante D. Pierdomenico, Istituto di Patologia Medica, Policlinico "S.S. Annunziata," Via dei Vestini, 66013 Chieti Scalo (Chieti), Italy E-mail: pierdomenico@unich.it

Received 10 March 2004; Revised 18 May 2004; Accepted 7 June 2004.

Abstract

Background: The prognostic value of left ventricular (LV) concentric remodeling in essential hypertension, and particularly in uncomplicated mild hypertension, is not yet completely clear. We investigated cardiovascular outcome in uncomplicated mild hypertensive patients with normal LV geometry and LV concentric remodeling.

Methods: The occurrence of fatal and nonfatal cardiovascular events was evaluated in 1088 uncomplicated mild hypertensive patients, 751 with normal LV geometry (LV mass index <125 g/m² in men and <110 g/m² in women and relative wall thickness <0.45) and 337 with LV concentric remodeling (LV mass index <125 g/m² in men and <110 g/m² in women and relative wall thickness 0.45).

Results: During follow-up (4.74 2.4 years, range 0.5 to 9.7 years) the event rates per 100 patient-years in subjects with normal LV geometry and LV concentric remodeling were 0.69 and 1.87, respectively. After adjustment for other covariates, Cox regression analysis showed that LV concentric remodeling (LV concentric remodeling versus normal LV geometry, RR 1.78, 95% CI 1.02 to 3.1, P < .05) was an independent predictor of cardiovascular events.

Conclusion: In a population with uncomplicated mild hypertension, patients with LV concentric remodeling have a worse prognosis than those with normal LV geometry.