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Profiles of echocardiographic features associated with blood pressure in patients with hypertension

Journal of Human Hypertension volume 39, pages 515–522 (2025)Cite this article

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Abstract

The multidimensional echocardiographic features associated with BP level are unclear. This study aimed to identify the multidimensional echocardiographic features associated with BP. In total, 2 092 adult participants (aged ≥18 years) with hypertension who underwent echocardiography in Beijing between July 2017 and January 2020 as part of the Multi-provincial Cohort for Hypertension study were enrolled. The associations between BP levels and echocardiographic features were investigated by multivariate regression analysis. After multivariable adjustment, a 1 SD (15.4 mmHg) increase in systolic BP was associated with a 0.21-mm increment (95% CI 0.06–0.35) in left atrial diameter, a 2.17-g/m2 increment (95% CI 1.46–2.88) in LV mass index, a 0.25-mm increment (95% CI 0.11–0.39) in ascending aorta diameter and a 0.03 decrement (95% CI −0.04, −0.01) in the E/A ratio. A 1 SD (10.1 mmHg) increase in diastolic BP was associated with a 1.51-g/m2 increment (95% CI 0.80–2.21) in LV mass index, a 0.46-mm increment (95% CI 0.31–0.61) in aortic root diameter, a 0.77-mm increment (95% CI 0.63–0.91) in ascending aorta diameter, and a 0.05 decrement (95% CI −0.07, −0.04) in E/A ratio. In conclusion, specific echocardiographic features were associated with the BP level. LV structure, ascending aorta diameter, and the E/A ratio were associated with systolic and diastolic BP. Left atrial diameter was positively associated only with systolic BP, and aortic root diameter was positively associated only with diastolic BP. These echocardiographic features may be valuable for early identification of target organ damage caused by elevated BP.

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Fig. 1: Correlations between blood pressure level and echocardiographic features.

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The data generated in this research can be made available from the corresponding authors upon request.

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Acknowledgements

We gratefully acknowledge the contribution of all the investigators from participating centers in the Multi-provincial Cohort for Hypertension for data collection.

Funding

This study was supported by National Key Research and Development Program of China(2022YFC3602501); National Natural Science Foundation of China (82073635, 82103962, and 12226005); Beijing municipal medical research institutes pilot reform project (grant number 2023-09) sponsored by Beijing Municipal Health Commission; and Capital Funds for health Improvement and Research (CFH 2024-2G-1052). The funding agencies had no role in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication.

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Author notes

  1. These authors contributed equally: Wenlang Zhao, Mingdan Wang.

Authors and Affiliations

  1. Center for Clinical and Epidemiologic Research, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, National Clinical Research Center for Cardiovascular Diseases, Ministry of Education, Beijing, 100029, China

    Wenlang Zhao, Mingdan Wang, Pan Zhou, Ziyu Wang, Xuan Deng, Jiangtao Li, Na Yang, Lizhen Han, Zhao Yang, Yue Qi & Jing Liu

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  1. Wenlang Zhao
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  2. Mingdan Wang
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Contributions

JingL, conceived the design and supervised the work. YQ and JingL critically revised the manuscript. WZ, MW, PZ, ZW, XD, JiangL, NY, LH, and ZY contributed to the acquisition, analysis, or interpretation of data for the work. WZ and MW drafted the manuscript and contribute equally to this manuscript. All gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

Corresponding authors

Correspondence to Yue Qi or Jing Liu.

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Ethical approval

This study was approved by the ethics committee of Beijing Anzhen Hospital, Capital Medical University (approval number 2017007), and was conducted in strict accordance with the principles of the Declaration of Helsinki.

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The authors declare no competing interests.

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Zhao, W., Wang, M., Zhou, P. et al. Profiles of echocardiographic features associated with blood pressure in patients with hypertension. J Hum Hypertens 39, 515–522 (2025). https://doi.org/10.1038/s41371-025-01034-4

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