Abstract P150: Blood Pressure Trajectories For 16 Years And The Development Of Left Ventricular Hypertrophy And Increased Left Atrial Size: The Korean Genome And Epidemiology Study

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Background: Single blood pressure (BP) measurement is associated with the development of target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between BP trajectories and the presence of LVH and LAE. Methods: This analysis enrolled participants who attended a health examination from 2001 to 2016 (visit 1 to 8) in Ansan cohort study. Among the initial total of 10030 participants, we excluded 1787 participants because their BP measurements were less than three times. An additional 5678 participants were excluded because they had no echocardiographic examinations to evaluate LVH at visit 8. Thus, we enrolled 2,565 participants (1267 males, 47.8 ± 6.7 years old) in this study. The previous studies selected mid-BP for identifying trajectories because Mid-BP showed the greatest predictive utility for cardiovascular diseases. Based on the previous study, we also used mid-BP to identify trajectories. The current sample has more than three times times of BP measurements over 16 years. Latent mixture modeling was used to identify trajectories in mid-BP over time. Linear logistic regression was used for assessing BP trajectories with the outcomes. Results: We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, n = 536), group 2 (36.2%, n = 928), group 3 (32.3%, n = 828), and group 4 (highest, 10.6%, n = 273). Compared with the lowest group, trajectories with elevated mid BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 1.432 (95% CI = 1.138 -1.802, P = 0.002) for group 2, 2.718 (95% CI = 2.103 - 3.513, P < 0.001) for group 3, and 2.480 (95% CI = 1.742 - 3.530, P < 0.001) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814 - 1.769, P = 0.358) for group 2, 1.599 (95% CI = 1.084 - 2.360, P = 0.018) for group 3, and 1.944 (95% CI = 1.212 - 3.118, P = 0.006) for group 4. Conclusions: Our study suggests that long-term higher mid-BP were an independent risk factor for having LVH among middle-aged males and females. Also, higher mid-BP was an independent risk factor for having future LAE in middle-aged females. Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.

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