Hypertension and smoking are associated with reduced regional left ventricular function in asymptomatic individuals: The Multi-Ethnic Study of Atherosclerosis

Boaz D. Rosen, Mohammed F. Saad, Steven Shea, Khurram Nasir, Thor Edvardsen, Gregory Burke, Michael Jerosch-Herold, Donna K. Arnett, Shenghan Lai, David A. Bluemke, João A.C. Lima

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


OBJECTIVES: This study sought to test the hypothesis that reduced regional left ventricular (LV) function is associated with traditional risk factors including hypertension, hypercholesterolemia, and smoking in asymptomatic individuals. BACKGROUND: Coronary artery disease is the main etiology of congestive heart failure in the U.S. and Europe. However, the relationship between risk factors for coronary artery disease and decreased myocardial function has not been studied systematically in asymptomatic individuals. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) is a cohort study designed to investigate the nature of atherosclerosis in asymptomatic individuals. A total of 1,184 participants (45 to 84 years old) underwent tagged cardiac magnetic resonance imaging. Regional LV function was quantified by analyzing peak systolic circumferential strain (Ecc) in regions corresponding to the left anterior descending (LAD), circumflex (LCX), and right coronary (RCA) territories. The association between risk factors and strains was studied using multiple linear regression. RESULTS: Higher diastolic blood pressure (DBP) was associated with lower Ecc (p ≤ 0.002). The Ecc's in the LAD territory of participants with DBP <80, 80 to 84, 85 to 89, and ≥90 mm Hg were -15.6%, -14.8%, -14.2%, and -13.7%, respectively (p < 0.001). Similar results were documented in other territories and after multivariable analysis. Smokers had lower Ecc in the LAD and RCA regions compared with nonsmokers. Furthermore, dose response relationship between cigarette consumption measured in pack-years and regional LV dysfunction by Ecc was noted (p ≤ 0.01 in LAD and RCA territories). Finally, combined diastolic hypertension and smoking was associated with a greater reduction of regional LV function. CONCLUSIONS: Higher diastolic blood pressure and smoking are associated with decreased regional LV function in asymptomatic individuals.

Original languageEnglish
Pages (from-to)1150-1158
Number of pages9
JournalJournal of the American College of Cardiology
Issue number6
StatePublished - Mar 21 2006

Bibliographical note

Funding Information:
This study was supported by the NHLBI grant (RO1-HL66075-01) and the MESA study contracts (NO1-HC-95162, NO1-HC-95168, and NO1-HC-95169). Dr. Lima is also supported by the Johns Hopkins Reynolds Center, and Dr. Rosen is supported by the Israeli Heart Society and the Organization of American Physician Fellowship for Medicine in Israel.

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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