Left Ventricular Diastolic Dysfunction and Its Associated Factors among Middle-Aged Hypertensive Patients: A Hospital-Based Comparative Cross-Sectional Study

Bably Verma; Rajat Jain; Deepak Bhasney; Rahul Ranajan

doi:10.55489/njmr.160420261405

Authors

Bably Verma Department of General Medicine, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Rajat Jain Department of General Medicine, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Deepak Bhasney Department of General Medicine, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Rahul Ranajan Department of Cardiology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India

DOI:

https://doi.org/10.55489/njmr.160420261405

Keywords:

Echocardiography, Tissue Doppler Imaging, Heart Failure with Preserved Ejection Fraction, Ventricular Remodeling, Medication Adherence, Blood Pressure

Abstract

Background: Hypertension often progresses silently to left ventricular diastolic dysfunction before overt symptoms appear, and its early detection in middle-aged individuals is crucial to prevent heart failure with preserved ejection fraction. The purpose was to assess the prevalence of diastolic dysfunction and associated risk factors among middle-aged hypertensive patients and to compare the findings with age-matched normotensive controls.

Methodology: This hospital-based comparative cross-sectional study enrolled 774 participants (387 hypertensive cases, 387 normotensive controls) aged 40-60 years. All underwent two-dimensional echocardiography with tissue Doppler imaging, and diastolic dysfunction was graded by the 2016 ASE/EACVI guidelines. Data were analysed in SPSS v25.0 using the chi-square test (p<0.05 significant).

Results: Diastolic dysfunction was more prevalent among cases (Grade 1, 33.07%; Grade 2, 14.47%) than controls (18.09% and 7.49%). Within the hypertensive group, substance use (p=0.003), drug compliance (p<0.001) and antihypertensive drug class (p=0.005) differed significantly by dysfunction status, whereas age, sex and socioeconomic status did not; smoking alone was not significant (p=0.57). Dysfunction was paradoxically more frequent among drug-compliant patients (55.27% vs 28.57%) and Telmisartan users, consistent with confounding by indication.

Conclusions: Diastolic dysfunction is common and frequently asymptomatic in middle-aged hypertensive adults, with Grade 1 predominating. Routine echocardiographic screening, stringent blood-pressure control and risk-factor modification are warranted to detect subclinical disease before symptomatic heart failure.

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