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Abstract: FR-PO1027

Association of Masked and Sustained Hypertension with Cardiac Magnetic Resonance Imaging Measures of Left Ventricular Structure and Function in Patients with Diabetes and CKD

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Dobre, Mirela A., Case Western Reserve University, Cleveland, Ohio, United States
  • Conger, Heather L., University Hospitals, Cleveland, Ohio, United States
  • Sarode, Anuja, University Hospitals, Cleveland, Ohio, United States
  • Fares, Anas, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
  • Connelly, Kim, St Michael's Hospital, Toronto, Ontario, Canada
  • Gaztanaga, Juan, NYU Winthrop Hospital, Mineola, New York, United States
  • Longenecker, Chris, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
  • Vergara-Martel, Armando, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
  • Weir, Matthew R., University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Rajagopalan, Sanjay, University Hospitals, Cleveland, Ohio, United States
Background

Diabetes and chronic kidney disease (CKD) are risk factors for hypertension phenotypes, such as masked and sustained hypertension which lead to increased cardiovascular risk. We aimed to describe the association of masked and sustained hypertension with structural and functional left ventricular measurements as assessed by cardiac magnetic resonance imaging (MRI) in type 2 diabetic patients with CKD.

Methods

A total of 38 adult patients enrolled in a prospective randomized controlled trial of mineralocorticoid receptor antagonism in patients with CKD (MAGMA) who had 24hr ambulatory blood pressure monitoring (ABPM) and cardiac MRI performed at study baseline were included. Masked hypertension was defined as SBP<130 mmHg in the office, and >125 by mmHg 24hr ABPM and resistant hypertension was defined as SBP>130 mmHg in the office and >125 mmHg by 24hr ABPM. Analysis of Variance was performed to assess the difference in mean MRI measures of cardiac structure and function for various hypertension phenotypes.

Results

The mean age (SD) was 62.5(8.9) years; 61% were women, and mean eGFR was 48.6 (20.3)ml/min/1.73m2. Compared to participants with controlled SBP (n=7), participants with masked (n=12) and sustained (n=17) hypertension had a higher left ventricular mass index (66.5±9 and 64.7±8.9 vs 58.6±7.7 g/m2 respectively (Figure). In adjusted models we found no association between hypertension phenotypes and T1 times, cardiac output, LVEF, LVEDV and LVESV.

Conclusion

Masked and sustained hypertension are associated with a high left ventricular mass index in individuals with CKD and diabetes. Larger trials are needed to better characterize MRI cardiac structural abnormalities in individuals at high cardiovascular risk.

Funding

  • Other NIH Support