To describe hypertension-related cardiovascular magnetic resonance (CMR) phenotypes
in the UK Biobank considering variations across patient populations.We studied 39
095 (51.5% women, mean age: 63.9 ± 7.7 years, 38.6% hypertensive) participants with
CMR data available. Hypertension status was ascertained through health record linkage.
Associations between hypertension and CMR metrics were estimated using multivariable
linear regression adjusting for major vascular risk factors. Stratified analyses were
performed by sex, ethnicity, time since hypertension diagnosis, and blood pressure
(BP) control. Results are standardized beta coefficients, 95% confidence intervals,
and P-values corrected for multiple testing. Hypertension was associated with concentric
left ventricular (LV) hypertrophy (increased LV mass, wall thickness, concentricity
index), poorer LV function (lower global function index, worse global longitudinal
strain), larger left atrial (LA) volumes, lower LA ejection fraction, and lower aortic
distensibility. Hypertension was linked to significantly lower myocardial native T1
and increased LV ejection fraction. Women had greater hypertension-related reduction
in aortic compliance than men. The degree of hypertension-related LV hypertrophy was
greatest in Black ethnicities. Increasing time since diagnosis of hypertension was
linked to adverse remodelling. Hypertension-related remodelling was substantially
attenuated in hypertensives with good BP control.Hypertension was associated with
concentric LV hypertrophy, reduced LV function, dilated poorer functioning LA, and
reduced aortic compliance. Whilst the overall pattern of remodelling was consistent
across populations, women had greater hypertension-related reduction in aortic compliance
and Black ethnicities showed the greatest LV mass increase. Importantly, adverse cardiovascular
remodelling was markedly attenuated in hypertensives with good BP control.
