Background. Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between the BP trajectories and the presence of LVH and LAE. Methods. We analyzed a total of 2,565 participants (1,267 males, 47.8 ± 6.7 years old) from the first biennial examination (2001-2002) of the Korean Genome and Epidemiology Study. The presence of LVH and LAE was identified by echocardiography performed at the 8^th biennial examination (2015-2016). Latent mixture modeling was used to identify trajectories in mid-BP ((systolic BP + diastolic BP)/2) over time. Linear logistic regression was used for assessing BP trajectories with the outcomes. Results. We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, n = 536), group 2 (36.2%, n = 928), group 3 (32.3%, n = 828), and group 4 (highest, 10.6%, n = 273). Compared with the lowest group, trajectories with elevated mid-BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 2.033 (95% CI = 1.462–2.827, ) for group 2, 3.446 (95% CI = 2.475–4.797, ) for group 3, and 4.940 (95% CI = 3.318–7.356, ) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814–1.769, ) for group 2, 1.599 (95% CI = 1.084–2.360, ) for group 3, and 1.944 (95% CI = 1.212–3.118, ) for group 4. Conclusions. Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.

中文翻译：

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16 年的血压轨迹与左心室肥大和左心房大小增加的发展：韩国基因组和流行病学研究

背景。单次血压 (BP) 测量值升高可能与高血压介导的靶器官损伤的发展有关，包括左心室肥大 (LVH) 和左心房 (LA) 扩大 (LAE)。然而，人们对 BP 的长期模式及其对 LVH 和 LAE 的影响知之甚少。我们评估了 BP 轨迹与 LVH 和 LAE 存在之间的关联。方法。我们分析了韩国基因组和流行病学研究的第一次两年期检查（2001-2002 年）的总共 2,565 名参与者（1,267 名男性，47.8 ± 6.7 岁）。^{LVH 和LAE}的存在通过第 8 天进行的超声心动图确定两年一次的考试（2015-2016）。潜伏混合模型用于识别中期 BP（（收缩压 + 舒张压）/2）随时间的轨迹。线性逻辑回归用于评估 BP 轨迹与结果。结果。我们确定了 4 个不同的中 BP 轨迹：第 1 组（最低，20.9%，n  = 536），第 2 组（36.2%，n  = 928），第 3 组（32.3%，n  = 828）和第 4 组（最高， 10.6%，n  = 273)。与最低组相比，通过多变量调整回归模型，中间血压升高的轨迹具有 LVH 和 LAE 的更大优势比。调整后的 LVH 奇数比为 2.033 (95% CI = 1.462–2.827,)对于第 2 组，3.446 (95% CI = 2.475–4.797,)第 3 组和 4.940 (95% CI = 3.318–7.356,)对于第 4 组。LAE 的调整奇数比为 1.200 (95% CI = 0.814–1.769,)对于第 2 组，1.599 (95% CI = 1.084–2.360,)第 3 组和 1.944 (95% CI = 1.212–3.118,)第 4 组。结论。较高的长期中期血压是中年人群心脏结构改变（如 LVH 和 LAE）的独立危险因素。