TY - JOUR
T1 - Target-organ damage and incident hypertension
T2 - The Korean genome and epidemiology study
AU - Kim, Seong Hwan
AU - Kim, Yong Hyun
AU - Kim, Jin Seok
AU - Lim, Sang Yup
AU - Jung, Jae Hyun
AU - Lim, Hong Euy
AU - Kim, Eung Ju
AU - Cho, Goo Yeong
AU - Baik, Inkyung
AU - Sung, Ki Chul
AU - Park, Juri
AU - Lee, Seung Ku
AU - Shin, Chol
N1 - Funding Information:
The study was supported by grants (2007-E71001-00, 2008-E71001-00, 2009-E71002-00, 2010-E71001-00, 2011- E71004-00, and 2012-E71005-00) from the Korean Centers for Disease Control and Prevention, and a grant (K1508021) from the Korea University Medical Center.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective: Hypertension is associated with cardiovascular organ damage. However, data are scanty on whether individual forms or combinations of subclinical target organ damage (TOD) increase the risk of incident hypertension in nonhypertensive study participants. Methods: A total of 1785 nonhypertensive participants from the fourth biennial examination (2007-2008) of the Korean Genome and Epidemiology Study were followed-up for four years. Echocardiographic left ventricular (LV) hypertrophy, LV diastolic dysfunction, increased carotid intima-media thickness (cIMT), and brachial-ankle pulse wave velocity (baPWV) were defined according to the current guidelines. Results: During 4-year follow-up, 19.9% of participants developed hypertension. In multivariate Cox proportional hazards models, the adjusted hazard ratios for developing hypertension were 1.39, 1.66, 1.48, and 0.78 for higher values of the LV mass index, cIMT, baPWV, and tissue Doppler e′ velocity, respectively (all P<0.01). The hazard ratios for LV hypertrophy, LV diastolic dysfunction, cIMT >75th percentile, and baPWV ≥ 1400cm/s were 1.61, 1.30, 1.86, and 2.07, respectively (all P<0.05). Compared with participants without any TOD, those with combinations of TOD types had significantly greater risk for developing hypertension (hazard ratio=2.12 and 3.98 for 1-2 and 3-4 TOD sites, respectively, all P<0.001). Conclusion: In the nonhypertensive population, each subclinical form of TOD independently predicts incident hypertension. In addition, the combinations of various forms of TOD are associated with stepwise increases in the risk for developing hypertension. The results suggest that asymptomatic TOD does not always exist in an intermediate stage in the cardiovascular continuum.
AB - Objective: Hypertension is associated with cardiovascular organ damage. However, data are scanty on whether individual forms or combinations of subclinical target organ damage (TOD) increase the risk of incident hypertension in nonhypertensive study participants. Methods: A total of 1785 nonhypertensive participants from the fourth biennial examination (2007-2008) of the Korean Genome and Epidemiology Study were followed-up for four years. Echocardiographic left ventricular (LV) hypertrophy, LV diastolic dysfunction, increased carotid intima-media thickness (cIMT), and brachial-ankle pulse wave velocity (baPWV) were defined according to the current guidelines. Results: During 4-year follow-up, 19.9% of participants developed hypertension. In multivariate Cox proportional hazards models, the adjusted hazard ratios for developing hypertension were 1.39, 1.66, 1.48, and 0.78 for higher values of the LV mass index, cIMT, baPWV, and tissue Doppler e′ velocity, respectively (all P<0.01). The hazard ratios for LV hypertrophy, LV diastolic dysfunction, cIMT >75th percentile, and baPWV ≥ 1400cm/s were 1.61, 1.30, 1.86, and 2.07, respectively (all P<0.05). Compared with participants without any TOD, those with combinations of TOD types had significantly greater risk for developing hypertension (hazard ratio=2.12 and 3.98 for 1-2 and 3-4 TOD sites, respectively, all P<0.001). Conclusion: In the nonhypertensive population, each subclinical form of TOD independently predicts incident hypertension. In addition, the combinations of various forms of TOD are associated with stepwise increases in the risk for developing hypertension. The results suggest that asymptomatic TOD does not always exist in an intermediate stage in the cardiovascular continuum.
KW - carotid intima-media thickness
KW - diastolic function
KW - hypertension
KW - left ventricular hypertrophy
KW - pulse wave velocity
KW - target organ damage
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U2 - 10.1097/HJH.0000000000000836
DO - 10.1097/HJH.0000000000000836
M3 - Article
C2 - 26771339
AN - SCOPUS:84957434093
VL - 34
SP - 524
EP - 531
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 3
ER -