EFFECT OF BMI AND UNCONTROLLED HYPERTENSION ON LEFT VENTRICULAR DYSFUNCTION IN HYPERTENSIVE PATIENTS WITH PRESERVED EJECTION FRACTION
Effect of BMI and uncontrolled hypertension on Left Ventricular Dysfunction in Hypertensive Patients with Preserved Ejection Fraction
Abstract
Abstract
Introduction: Hypertension and elevated body mass index (BMI) are established independent predictors of cardiovascular morbidity and mortality. Objective: The aim of this study was to compare the effects of BMI and uncontrolled hypertension on echocardiographically assessed parameters related to left ventricular dysfunction in hypertensive patients with preserved ejection fraction. Methods: This prospective analytical cross-sectional study was conducted between 2024 and 2025 at the Public Clinical Hospital Tetovo, Republic of North Macedonia. A total of 92 patients aged 18 years or older with a clinical diagnosis of arterial hypertension and preserved ejection fraction (EF greater than 50 percent) were included. Results: The presence of uncontrolled hypertension was significantly associated with disease duration greater than 5 years (p 0.0013). No significant association was observed between controlled and uncontrolled hypertension and BMI categories (p 0.2617). Overweight status was significantly associated with duration of hypertension greater than 5 years (p 0.0177). No significant association was found between BMI categories and gender (p 0.6026). Regarding BMI categories, significantly worse echocardiographic parameters were observed in overweight and obese patients compared to normal weight patients, including relative wall thickness (p 0.0403), left ventricular mass index (p 0.0001), left atrial volume index (p 0.0101), and Tei index (p 0.0301). Global longitudinal strain, ejection fraction and E to e prime ratio were non-significantly worse in overweight and obese patients compared to normal-weight patients. Significantly worse global longitudinal strain (p 0.00001) and Tei index (p 0.00005) values were observed in patients with uncontrolled hypertension compared to those with controlled arterial hypertension. No significant differences were found between controlled and uncontrolled hypertension groups regarding ejection fraction, relative wall thickness, left ventricular mass index, left atrial volume index and E to e prime ratio. Conclusion: Larger prospective cohort studies are needed to clarify causal relationships and to better understand the impact of controlling established and emerging risk factors.
Keywords: echocardiography, hypertension, left ventricular dysfunction, preserved ejection fraction, BMI, obesity
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