Assessment of Cardiovascular Risk Factors in Prehypertensive Subjects and Their Association with Left Ventricular Geometry
Main Article Content
Abstract
Background: Prehypertension, defined as systolic blood pressure of 120–139 mmHg or diastolic blood pressure of 80–89 mmHg, represents an intermediate cardiovascular risk state that is associated with progressive organ damage. The impact of prehypertension on left ventricular (LV) geometry and its clustering with other cardiovascular risk factors remains underexplored in South Asian populations.
Objectives: To assess cardiovascular risk factor burden in prehypertensive subjects and to determine the association between prehypertension and left ventricular geometric patterns compared with normotensive controls.
Methods: This hospital-based case-control study enrolled 100 subjects (50 prehypertensive cases and 50 normotensive controls) aged 20–60 years. Anthropometric measurements, fasting lipid profile, blood glucose, and inflammatory markers were recorded. Two-dimensional echocardiography was performed to assess left ventricular mass index (LVMI), relative wall thickness (RWT), and LV geometric patterns using the Ganau classification.
Results: Prehypertensive subjects demonstrated significantly higher BMI, waist circumference, fasting glucose, total cholesterol, LDL-C, triglycerides, and lower HDL-C compared to normotensives (p<0.05 for all). LV geometric abnormalities were present in 56% of prehypertensive subjects versus 8% of controls (p<0.001). Concentric remodelling was the most prevalent pattern (28%), followed by concentric hypertrophy (18%) and eccentric hypertrophy (10%). LVMI and RWT were significantly higher in prehypertensives (104.6 ± 18.3 g/m² vs. 82.4 ± 14.1 g/m², p<0.001; 0.44 ± 0.06 vs. 0.37 ± 0.05, p<0.001). LVMI correlated positively with systolic BP, BMI, fasting glucose, LDL-C, and triglycerides.
Conclusion: Prehypertension is associated with a significantly higher cardiovascular risk factor burden and adverse LV geometric remodelling even before overt hypertension develops. Early echocardiographic evaluation and aggressive risk factor modification are warranted in prehypertensive individuals.