门诊高血压病患者心血管危险分层与血压控制的研究

目的了解门诊高血压病患者的心血管危险分层与血压控制的关系.方法随机入选门诊原发性高血压患者106例,使用统一的表格询问和记录相关病史和检测、检查结果,按中国高血压防治指南的心血管危险分层方法进行分层.据危险分层的差异进行相应的治疗,2个月后复诊.结果(1)76.9%的男性患者有2个和2个以上的危险因素,而女性只有57.4%(P<0.05);(2)约60%高血压病患者心血管危险分层为高危和很高危,34.0%为中危,7.5%为低危.(3)经过规则治疗后,高血压病患者血压下降至正常,收缩压从163.77±16.82mmHg下降到134.56±14.45mmHg,舒张压从94.55±11.79mmHg下降为81.20±8.37mmHg(P<0.05).心血管危险分层很高危百分比下降,从31.1%下降为14.2%(P<0.01).低危百分比上升,从7.5%上升为14.2%(P<0.05).结论对高血压病患者进行心血管危险分层有助于高血压及其并发症的防治.     

高血压病亚临床靶器官损害的评估对心血管危险分层的影响

目的:探讨除了血压水平危险分层外,不同亚临床靶器官损害的检测评估对高血压病患者心血管危险分层的影响。方法: 258例住院高血压病患者,除了常规检测项目外,还进行心脏彩超及颈动脉内中膜层厚度的测量,依据2005年中国高血压防治指南,对血压水平及添加亚临床靶器官损害评估后的高血压病患者进行危险分层。结果: 高血压病患者根据血压水平危险分层。低危 60例（23.2%）;中危115例（44.6%）;高危83例（32.2%）。这些低中危的患者通过亚临床靶器官损害评估后再行危险分层,其高危组患者所占比率明显升高,为219例（84.9%）,相比较血压水平危险分层具有明显的统计学差异（P<0.01）。结论: 亚临床靶器官损害的检测评估可提高高血压病高危患者的检出率。     

循环EPCs CD34^＋水平与高血压病患者心血管危险因素的关系

目的探讨能否将循环内皮祖细胞(EPCs)CD34 水平作为评价高血压病患者心血管危险度的标志。方法高血压病患者组62例,对照组20例。高血压病患者采用Framingham心血管危险因素积分分层心血管危险因素,分为低危组18例,中危组14例,高危组17例,极高危组13例。作外周血循环EPCs CD34 水平与Framingham心血管危险因素积分的相关性分析。结果各研究组高血压病患者外周循环EPCs CD34 水平随着其心血管危险程度的增加,逐步下降,各组间比较有统计学意义(P<0.05)。EPCs CD34 水平与Framingham心血管危险因素积分呈负相关关系(r=-0.875,P<0.01)。结论高血压病患者循环EPCs CD34 水平下降与心血管危险因素有显著的相关性。循环EPCs CD34 水平可以作为高血压病患者心血管危险度的标志。     

高血压病患者中医体质分类及与心血管危险因素的相关研究

目的 对高血压病患者进行体质分类,并比较不同体质类型的心血管危险因素的相关性.方法 以社区人群抽样调查,采用中医体质分类标准评定和以心血管危险因素判断.结果 被调查的高血压病患者623例,按中医体质分类标准分为腻滞质345例(55.4%),燥红质138例(22.2%),倦晄质36例(5.8%),正常质104例(16.7%).按照心血管危险因素分层,中危和高危人群占97.7%,在这些中危和高危的患者中腻滞质患者明显多于其他体质类型的患者,差异有统计学意义(P=0.013);心血管危险因素分析,腻滞质高血压患者年龄偏大、吸烟和血脂异常比例明显高于其他体质类型的患者,差异有统计学意义(P分别为0.001、0.003、0.016).结论 原发性高血压患者是以腻滞质和燥红质两种体质类型为主要特征,中医临床的辨证分型是从两种体质基础上发展而成的,体质类型决定了证型;腻滞质的高血压患者比其他体质类型的高血压患者心血管危险因素更高,进行早期干预更为重要.     

血浆纤维蛋白原对不稳定型心绞痛危险分层的价值

目的 :探讨血浆纤维蛋白原 (Fib)水平对不稳定型心绞痛 (UA)危险分层的临床价值。方法 :测定10 9例UA患者血浆Fib并与 35例稳定型心绞痛 (SA)患者相对照 ,据血浆Fib >4 .0 0 g/L和Fib <4 .0 0 g/L将UA患者分为Fib升高组 (5 8例 )和Fib正常组 (5 1例 ) ,观察住院期间心血管事件 (包括顽固性心绞痛、急性心肌梗死和心源性死亡 )发生率。结果 :10 9例UA患者血浆Fib较SA患者明显升高 [(4.89± 1.6 2 )∶ (3.85± 0 .74 )g/L ,P <0 .0 1],UA患者中血浆Fib升高组心血管事件发生率明显高于Fib正常组 (41.4 %∶ 5 .9% ,P <0 .0 1)。结论 :血浆Fib水平能预测UA患者住院期间心血管事件 ,可作为UA患者危险分层的一项血浆学指标     

动脉硬度与高血压患者心血管危险分层的关系--一种新的、简便的测定动脉硬度的方法

目的研究动脉硬度指数(ASI)预测高血压患者心血管危险的价值.方法用我们研制的YF-1血管硬度测量仪测量248例高血压病人的ASI,并进行了危险因素调查.结果①高血压并发症组的ASI(162.2±53.3)比单纯性高血压组(136.0±50.7)高(P＜0.01).②低危组、中危组、高危组和极高危组的ASI逐渐增大,任意两组比较均具有显著性差异(P＜0.01).③177例无并发症的高血压患者的Framingham危险积分与ASI有较好的相关性(r=0.435,P＜0.01).结论ASI是一个较好的预测心血管病危险的指标.     

不稳定型心绞痛危险分层中血纤维蛋白原浓度的临床意义

目的　本文旨在探讨血纤维蛋白原浓度在不稳定型心绞痛不同危险分层中的变化。方法　将 162例入选的不稳定型心绞痛患者 ,分成高危组 ( n=3 4)、中危组 ( n=5 8)及低危组 ( n=70 ) ,同时测定三组血浆纤维蛋白原及心脏肌钙蛋白 T( c Tn T)浓度。结果　三组血纤维蛋白原浓度有显著性差异 ,随危险分层的增高 ,血纤维蛋白原浓度有增加的趋势 [( 3 98.3 6± 12 6.3 2 ) m g/ dl( 42 5 .75± 14 3 .5 2 ) m g/ dl及 ( 473 .15± 160 .61) mg/ dl,P<0 .0 1]。结论　血纤维蛋白原浓度有助于不稳定型心绞痛的危险分层 ;血纤维蛋白原升高提示 ,不稳定型心绞痛患者危险分层高 ,有较强的血栓形成趋势。     

硝苯地平控释片伍用珍菊降压片治疗舒张期高血压的观察

目的　观察硝苯地平控释片 (商品名拜新同 )伍用珍菊降压片治疗对一般治疗效果不佳的中青年舒张期高血压病的疗效。方法　 38例中青年原发性舒张期高血压患者为观察对象 ,轻中度高血压 35例 ,3例为重度。拜新同 30mg 片 ,每日 1次晨服 ,珍菊降压片每日 3次 ,每次 1片。前 18例于就诊当时即予珍菊降压片一片 ,拜新同一片口服 ,2小时后再测血压 ,心率。前 18例及后 2 0例均在用药前 ,用药第 2、4周末测右臂坐位血压及心率 ,并观察症状改变情况。结果　本方法对均有高血压患者均有效 ,且高血压引发的症状好转 ,无明显不良反应。前 18例患者用药前的收缩压为 (140 8±11 4)mmHg ,用药 2小时为 (131 6± 7 6 )mmHg(P >0 0 5 )。舒张压为 (10 5 4± 6 5 )mmHg降至 (91 3±5 4)mmHg(P <0 0 5 )。 38例用药前收缩压为 (141 6± 11 6 )mmHg ,于第 2、4周末转为 (131 9± 7 8)mmHg、(131 4± 7 6 )mmHg(P >0 0 5 ) ,舒张压由原先的 (10 5 8± 6 6 )mmHg降至 (90 9± 5 6 )mmHg、(90 8± 5 6 )mmHg(P <0 0 5 )。结论　拜新同伍用珍菊降压片值得在“难治”的中青年舒张期高血压病人中验证、应用     

氨氯地平和依那普利对老年纯收缩期高血压患者动态血压的影响

目的　比较氨氯地平和依那普利对老年纯收缩期高血压患者的 2 4h动态血压的影响。方法　将 6 0例轻中度纯收缩期高血压老年患者随机分为两组 ,每组 30例。分别选用氨氯地平片 5mg和依那普利片 10mg ,每日一次 ,共 4周。用药前后进行 2 4h动态血压监测。结果　两组药物治疗第 4周末 2 4h动态血压发现 ,2 4h平均收缩压、脉压、舒张压、平均动脉压均较服药前明显降低 ,统计学上有显著性差异。氨氯地平组治疗后总体收缩压和舒张压分别下降 17.0 3± 8.5 5mmHg和 4 .83± 4 .82mmHg ;平均动脉压下降了 8.86± 4 .76mmHg ,依那普利组治疗后总体收缩压和舒张压分别下降 14 .30± 7.2 6mmHg和 5 .97± 2 .87mmHg ,平均动脉压下降了 8.74± 3.0 7mmHg ,组间比较收缩压下降幅度无差异 (P =0 .187) ,脉压下降幅度有统计学意义 (P =0 .0 0 5 )。氨氯地平组脉压差下降幅度大于依那普利组 (16 .97± 14 .0 6mmHg比 8.33± 7.84mmHg ,P =0 .0 0 5 ) ,两药对舒张压的影响组间比较无统计学差异。两组有效率相似 (76 .7%比 73.3% ,P =0 .76 6 ) ,达标率的差异无统计学意义 (6 6 .7%比 5 6 .7% ,P =0 .4 2 6 )。氨氯地平组发生胫前水肿 2例 ,依那普利组咳嗽 5例。结论　氨氯地平与依那普利对老年纯收缩期高血压均有效 ,尤其     

降压治疗对中国脑血管病患者脑卒中再发预防的多中心随机双盲对照临床研究

目的评估降压治疗对脑血管病患者脑卒中再发的影响。方法入选近5年内有脑卒中或短暂性脑缺血发作病史的患者,且无研究药物适应证或禁忌证,无血压入选标准。研究为大样本、随机、双盲、安慰剂对照临床试验。导入期4周后,1520例患者被随机分为培哚普利(或加吲哒帕胺)治疗组或安慰剂对照组,随访治疗4年。主要终点是脑卒中事件,次要终点包括心血管死亡,心肌梗死,全因死亡等。结果762例被分为治疗组,758例为对照组。治疗组与对照组两组患者基础临床特征相似。治疗组与对照组的男性分别为70·8%和70·5%;脑卒中史占93·8%和93·4%;基础血压为(145·3±20·2)/(86·8±11·1)mmHg(1mmHg=0·133kPa)和(145·3±20·3)/(87·2±10·8)mmHg;平均年龄为(63·9±7·5)岁和(63·8±7·7)岁。随访4年,治疗组较对照组血压平均下降14/6mmHg,治疗组脑卒中再发率(8·8%)较对照组(19·4%)明显减少,相对危险下降55%(P<0·001);心肌梗死发生(1·4%比2·8%)危险下降48%(P=0·070);心血管死亡(3·6%比6·6%)危险减少45%(P=0·010);总死亡(6·3%比9·8%)危险减少36%(P=0·010)。降压治疗对男性或女性、中年或老年、有或无高血压史、脑梗死史或脑出血史患者均有益。结论降压治疗对脑血管病患者的脑卒中再发的预防是有益的。     

Prevalence of left ventricular hypertrophy in patients with mild hypertension in primary care: impact of echocardiography on cardiovascular risk stratification

BACKGROUND: Left ventricular hypertrophy (LVH) is an important predictor of cardiovascular risk, and its detection contributes to risk stratification. The aims of the present study were to estimate the prevalence of echocardiographic LVH and to evaluate the influence of echocardiography (ECHO) on cardiovascular risk stratification in hypertensive patients presenting in primary care. METHODS: In this cross-sectional study, 250 patients recently diagnosed with mild hypertension underwent clinical evaluation including electrocardiography (ECG), microalbuminuria measurement, 24-h blood pressure monitoring and ECHO. Level of cardiovascular risk was stratified, initially using routine procedures including ECG to assess target organ damage and then again after detection of LVH by ECHO. RESULTS: The frequency of echocardiographic LVH was 32%, substantially higher than that detected by ECG (9%). Initial cardiovascular risk stratification yielded the following results: 30% low risk, 49% medium risk, 16% high risk, and 5% very high risk subjects. The detection of LVH by ECHO provoked a significant change in the risk strata distribution, particularly in those patients initially classified as being at medium risk. In this group, 40% of subjects were reclassified as high risk subjects according to ECHO information. The new classification was as follows: 23% low risk, 30% medium risk, 42% high risk, and 5% very high risk subjects. CONCLUSIONS: A substantial proportion of mildly hypertensive patients presenting in primary care have LVH determined by ECHO. Our results suggest that this procedure could significantly improve cardiovascular risk stratification in those patients with multiple risk factors, but no evidence of target organ damage by routine investigations.     

The impact of plasma high-sensitivity C-reactive protein levels on cardiovascular risk stratification of hypertensive patients: results of the ICEBERG study

The Intensive/Initial Cardiovascular Examination Regarding Blood Pressure Levels: Evaluation of Risk Groups (ICEBERG) study focused on the impact of high-sensitivity C-reactive protein (hs-CRP) measurement on cardiovascular risk evaluation. The ICEBERG study comprised 2 subprotocols. Each subprotocol had 2 patient profiles: patients previously diagnosed with essential hypertension and under medical treatment and patients with systolic blood pressure 130 mm Hg or higher, or diastolic blood pressure 85 mm Hg or higher, with no treatment for at least 3 months before inclusion. Measurement of hs-CRP and cardiovascular risk stratification were performed according to European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines. A total of 1817 patients were analyzed. In 1 group, the percentage of patients in "high" plus "very high" added-risk groups increased from 59.2% to 72.7% when hs-CRP data were added to routine serum biochemistries. In another, the increase was from 66.9% to 77.9%, whereas in a third group, it changed from 65.1% to 77.2%. The use of plasma hs-CRP levels might help in stratifying hypertensive patients into specific risk groups and modifying preventive approaches.     

上海市普陀区高血压社区规范管理的模式和效果探讨

目的在社区进行高血压规范管理,观察高血压治疗率和控制率,了解血压水平和心血管危险分层的变化。方法 2009-04-2010-04在上海市普陀区4个社区2048人中检查出高血压患者977例,按照心血管危险因素分层实行分级管理1年,设立健康管理专员进行管理,随访包括血压测量、健康教育和治疗方案调整。结果高血压患者977例一年的规范管理率88.9%;管理前后高血压的治疗率从66.7%(652/977)提高到73.6%(655/890),高血压控制率从41.3%(403/977)提高到61.8%(550/890),分别增加了6.9%和20.5%,差异有统计学意义(P<0.01);与基线调查时相比,1级高血压患者减少22.8%,2级高血压患者减少4.3%,3级高血压患者减少0.3%;在重新评估的心血管危险因素分层状况中,低危患者人数增加0.2%,中危患者人数减少0.6%,高危患者人数增加1.2%,很高危患者人数减少0.8%;吸烟者、超重者、缺少运动者分别减少0.8%、0.4%、2.0%,血脂异常者减少4.9%(P<0.05);总胆固醇、三酰甘油和低密度脂蛋白总胆固醇分别降低0.20、0.30和0.14mmol/L(P<0.01)。结论健康管理专员模式在社区是能被患者接受的,规范管理后,使社区高血压患者的血压水平下降,高血压控制率得到了明显的提高。     

Diabetes and Hypertension: Pathogenesis,Prevention and Treatment

Hypertension occurs in approximately 30% of patients with type 1 diabetes and from 50 to 80% of patients with type 2 diabetes. Although the pathogenesis of hypertension is distinct in each type, hypertension markedly enhances the already high risk of cardiovascular and renal disease in types 1 and 2 and implications for treatment are similar in both. The threshold for blood pressure treatment in diabetic patients is generally agreed to be 140/90 mm/hg with a target BP of < 130/80. So‐called “lifestyle modifications” play an important role in therapy, particularly in type 2 patients, by decreasing blood pressure and improving other risk factors for cardiovascular disease. Indeed non‐pharmacologic interventions have been demonstrated to prevent the development of type 2 diabetes in patients at high risk to develop the disease. Aggressive anti‐hypertensive drug treatment is warranted given the high risk associated with the combination of diabetes and hypertension and the demonstrated effectiveness of anti‐hypertensive treatment in reducing cardiovascular morbidity and mortality in this group of patients. ACE inhibitors and ARBs are the cornerstones of pharmacologic management, in no small part because of the renoprotective effects of these agents in antagonizing the development and progression of diabetic renal disease. Multiple agents, including diuretics, will usually be required to attain target blood pressure levels.     

Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients

BACKGROUND: Current guidelines for the management of hypertension rest almost completely on the measurement of systolic and diastolic blood pressure. However, the arterial blood pressure wave is more correctly described as consisting of a pulsatile (pulse pressure) and a steady (mean pressure) component. OBJECTIVE: To explore the independent roles of pulse pressure and mean pressure as determinants of cardiovascular prognosis in older hypertensive patients. METHODS: This meta-analysis, based on individual patient data, pooled the results of the European Working Party on High Blood Pressure in the Elderly trial (n = 840), the Systolic Hypertension in Europe Trial (n = 4695), and the Systolic Hypertension in China Trial (n = 2394). The relative hazard rates associated with pulse pressure and mean pressure were calculated using Cox regression analysis, with stratification for the 3 trials and with adjustments for sex, age, previous cardiovascular complications, smoking, and treatment group. RESULTS: A 10-mm Hg wider pulse pressure increased the risk of major cardiovascular complications; after controlling for mean pressure and the other covariates, the increase in risk ranged from approximately 13% for all coronary end points (P = .02) to nearly 20% for cardiovascular mortality (P = .001). In a similar analysis, mean pressure predicted the incidence of cardiovascular complications but only after removal of pulse pressure as an explanatory variable from the model. Furthermore, the probability of a major cardiovascular end point increased with higher systolic blood pressure; at any given level of systolic blood pressure, it also increased with lower diastolic blood pressure, suggesting that the wider pulse pressure was driving the risk of major complications. CONCLUSIONS: In older hypertensive patients, pulse pressure not mean pressure is the major determinant of cardiovascular risk. The implications of these findings for the management of hypertensive patients should be further investigated in randomized controlled outcome trials in which the pulsatile component of blood pressure is differently affected by antihypertensive drug treatment.     

ESH-ESC Guidelines for the Management of Hypertension

The following is a brief statement of the 2003 European Society of Hypertension (ESH)-European Society of Cardiology (ESC) guidelines for the management of arterial hypertension.The continuous relationship between the level of blood pressure and cardiovascular risk makes the definition of hypertension arbitrary. Since risk factors cluster in hypertensive individuals, risk stratification should be made and decision about the management should not be based on blood pressure alone, but also according to the presence or absence of other risk factors, target organ damage, diabetes, and cardiovascular or renal damage, as well as on other aspects of the patient's personal, medical and social situation. Blood pressure values measured in the doctor's office or the clinic should commonly be used as reference. Ambulatory blood pressure monitoring may have clinical value, when considerable variability of office blood pressure is found over the same or different visits, high office blood pressure is measured in subjects otherwise at low global cardiovascular risk, there is marked discrepancy between blood pressure values measured in the office and at home, resistance to drug treatment is suspected, or research is involved. Secondary hypertension should always be investigated.The primary goal of treatment of patient with high blood pressure is to achieve the maximum reduction in long-term total risk of cardiovascular morbidity and mortality. This requires treatment of all the reversible factors identified, including smoking, dislipidemia, or diabetes, and the appropriate management of associated clinical conditions, as well as treatment of the raised blood pressure per se. On the basis of current evidence from trials, it can be recommended that blood pressure, both systolic and diastolic, be intensively lowered at least below 140/90 mmHg and to definitely lower values, if tolerated, in all hypertensive patients, and below 130/80 mmHg in diabetics.Lifestyle measures should be instituted whenever appropriate in all patients, including subjects with high normal blood pressure and patients who require drug treatment. The purpose is to lower blood pressure and to control other risk factors and clinical conditions present.In most, if not all, hypertensive patients, therapy should be started gradually, and target blood pressure achieved progressively through several weeks. To reach target blood pressure, it is likely that a large proportion of patients will require combination therapy with more than one agent. The main benefits of antihypertensive therapy are due to lowering of blood pressure per se. There is also evidence that specific drug classes may differ in some effect or in special groups of patients. The choice of drugs will be influenced by many factors, including previous experience of the patient with antihypertensive agents, cost of drugs, risk profile, presence or absence of target organ damage, clinical cardiovascular or renal disease or diabetes, patient's preference.     

Intensive cardiovascular examination regarding blood pressure levels: evaluation of risk groups. ICEBERG study

Objective. Assessment of total cardiovascular risk level is crucial for approaching hypertensive patients. Therefore, the aim of the Intensive/Initial Cardiovascular Examination regarding Blood pressure levels: Evaluation of Risk Groups (ICEBERG) study is to determine cardiovascular risk evaluation and stratification of subjects with high normal and high blood pressure (BP≥130/85 mmHg), and to evaluate the impact of laboratory tests on this stratification. Methods. ICEBERG was an epidemiological study conducted at 20 university hospitals and 197 primary healthcare centers. A total of 10,313 patients, who were diagnosed with high BP and under antihypertensive treatment or not antihypertensive under treatment at least for the last 3 months were selected. Besides routine clinical evaluation, microalbuminuria (MAU) and high sensitive C-reactive protein (hs-CRP) tests, echocardiography (Echo) and carotid ultrasonography (USG) were performed in selected arms. The patients were stratified into low, moderate, high and very high added risk groups as described by the European Society of Hypertension/European Society of Cardiology Guidelines Committee (2003). Results. Upon routine evaluation, the percentage of “high and very high added cardiovascular risk” groups was between 51.2% and 60.7% in different study arms. This percentage increased to 62.9% by subsequent serum biochemistry assessment and to 76.2% by hs-CRP test results. Switching upwards to “high and very high added risk” groups was around 6% when MAU results were used, with a 4.9% upwards switch to “high and very high added risk” groups when Echo was performed; this proportion increased by 6.8%, when carotid USG was taken into account. Conclusion. Cardiovascular risk evaluation by intensive cardiovascular examination including Echo and carotid USG provided more accurate risk stratification. Furthermore, a simple test to demonstrate presence of MAU usable at primary healthcare level will also help to evaluate the patient's risk profile better than routine assessment methods alone.     

Prognostic value of morning surge of blood pressure in middle‐aged treated hypertensive patients

We investigated the prognostic value of morning surge (MS) of blood pressure (BP) in middle‐aged treated hypertensive patients. The occurrence of a composite end point (coronary events, stroke, and heart failure requiring hospitalization) was evaluated in 1073 middle‐aged treated hypertensive patients (mean age 49 years). Patients with preawakening MS of BP above the 90th percentile (27/20.5 mm Hg for systolic/diastolic BP) were defined as having high MS of BP. During the follow‐up (mean 10.9 years), 131 cardiovascular events occurred. After adjustment for various covariates, including known risk markers and ambulatory BP parameters, patients with high MS of systolic BP (hazard ratio 1.81, 95% confidence interval 1.10‐2.96) and those with high MS of diastolic BP (hazard ratio 1.98, 95% confidence interval 1.19‐3.28) were at higher cardiovascular risk than those with normal MS. In middle‐aged treated hypertensive patients, high MS of systolic and diastolic BP is independently associated with increased cardiovascular risk.     

Should we perform an echocardiogram in hypertensive patients classified as having low and medium risk?

BACKGROUND: Left ventricular hypertrophy is an important predictor of cardiovascular risk and its detection contributes to risk stratification. However, echocardiography is not a routine procedure and electrocardiography (ECG) underestimates its prevalence. OBJECTIVE: To evaluate the prevalence of echocardiographic left ventricular hypertrophy in low and medium risk non-treated hypertensive subjects, in order to find out the percentage of them who would be reclassified as high risk patients. METHODS: Cross-sectional, multicenter study was performed in hospital located hypertension units. An echocardiogram was performed in 197 previously untreated hypertensive patients, > 18 years, classified as having low (61%) or medium (39%) risk, according to the OMS/ISH classification. The presence of left ventricular hypertrophy was considered if left ventricular mass index was > or = 134 or 110 g/m(2) in men and women, respectively (Devereux criteria). A logistic regression analysis was performed to identify factors associated to left ventricular hypertrophy. RESULTS: The prevalence of left ventricular hypertrophy was 23.9% (95% CI:17.9-29.9), 25.6% in men and 22.6% in women. In the low risk group its prevalence was 20.7% and in medium risk group 29.5%. Factors associated to left ventricular hypertrophy were: years since the diagnosis of hypertension, OR:1.1 (95% CI:1.003-1.227); systolic blood pressure, OR:1.08 (95% CI:1.029-1.138); diastolic blood pressure, OR:0.9 (95% CI:0.882-0.991); and family history of cardiovascular disease, OR:4.3 (95% CI:1.52-12.18). CONCLUSIONS: These findings underline the importance of performing an echocardiogram in low and high risk untreated hypertensive patients in which treatment would otherwise be delayed for even one year.