Inclusion

N
Excluded 72,271
Included 25,946

Exclusion Reason

N
AFIB Combined 2,609
Age < 18 467
AI >= moderate 1,336
AS >= moderate 3,104
CHF 404
COPD 549
Diastolic Dysfunction 20,625
Enlarged Atrium 9,454
LBBB/RBBB 1,587
LVEF <= 50 7,901
Missing Data 16,871
MR >= moderate 5,428
MS 764
Previous Malignant Cancer 1,172

#HTN VS No HTN histogram

Red = HTN Blue = No HTN

Table 1

Demographic and clinical features - All Patients
Overall No HTN HTN p Missing
n 25946 12654 13292
Age (median [IQR]) 59.0 [44.0, 69.0] 49.0 [35.0, 62.0] 66.0 [56.0, 75.0] <0.001 0.0
male = 1 (%) 12516 (48) 5736 (45) 6780 (51) <0.001 0.0
inpatient = 1 (%) 13127 (51) 4532 (36) 8595 (65) <0.001 0.0
octogenarian = 1 (%) 2030 ( 8) 279 ( 2) 1751 (13) <0.001 0.0
BSA (median [IQR]) 1.8 [1.7, 2.0] 1.8 [1.6, 1.9] 1.8 [1.7, 2.0] <0.001 6.9
BMI (median [IQR]) 25.4 [22.8, 28.6] 24.4 [21.9, 27.5] 26.1 [23.5, 29.4] <0.001 18.1
overweight = 1 (%) 11264 (53) 4341 (44) 6923 (60) <0.001 18.1
obese = 1 (%) 3824 (18) 1263 (13) 2561 (22) <0.001 18.1
DM = 1 (%) 3338 (13) 451 ( 4) 2887 (22) <0.001 0.0
IHD = 1 (%) 3009 (12) 606 ( 5) 2403 (18) <0.001 0.0
SystolicBloodPressure (median [IQR]) 125.0 [113.0, 140.0] 120.0 [108.0, 130.0] 133.0 [120.0, 148.0] <0.001 16.2
DiastolicBloodPressure (median [IQR]) 73.0 [65.0, 80.0] 70.0 [63.0, 80.0] 75.0 [67.0, 83.0] <0.001 16.3
RVSP (median [IQR]) 29.0 [25.0, 34.0] 28.0 [25.0, 32.0] 31.0 [27.0, 36.0] <0.001 0.0
RVSP_Above_40 = 1 (%) 2421 ( 9) 597 ( 5) 1824 (14) <0.001 0.0
LVEF (median [IQR]) 60.0 [60.0, 60.0] 60.0 [60.0, 60.0] 60.0 [60.0, 63.0] <0.001 17.2
LVEDD (median [IQR]) 4.4 [4.1, 4.8] 4.5 [4.2, 4.8] 4.4 [4.1, 4.7] <0.001 17.2
LVESD (median [IQR]) 2.7 [2.4, 3.0] 2.7 [2.5, 3.0] 2.7 [2.4, 3.0] <0.001 17.3
LeftVentricleInterventricularSeptumThickness (median [IQR]) 1.0 [0.9, 1.1] 0.9 [0.8, 1.0] 1.0 [0.9, 1.1] <0.001 0.8
LeftVentricleEstimatedMass (median [IQR]) 137.2 [112.7, 164.5] 128.6 [105.6, 156.1] 144.3 [119.0, 173.3] <0.001 2.0
LeftVentricleEstimatedMassIndex (median [IQR]) 75.0 [64.0, 88.0] 72.0 [61.0, 83.0] 79.0 [67.0, 93.0] <0.001 8.4
LeftAtriumAPDiameter (median [IQR]) 3.5 [3.2, 3.7] 3.4 [3.1, 3.7] 3.5 [3.2, 3.8] <0.001 1.7
MitralInflowPeakEWave (median [IQR]) 73.3 [61.6, 86.0] 76.0 [64.0, 88.4] 70.7 [59.6, 83.8] <0.001 6.4
MitralInflowEARatio (median [IQR]) 1.0 [0.8, 1.4] 1.2 [0.9, 1.6] 0.9 [0.7, 1.1] <0.001 8.0
MitralInflowPeakAWave (median [IQR]) 70.0 [56.3, 85.7] 62.4 [50.4, 76.0] 78.0 [64.2, 92.8] <0.001 8.0
MitralInflowDecelerationTime (median [IQR]) 205.0 [174.0, 246.0] 198.0 [169.0, 232.0] 213.4 [179.0, 256.0] <0.001 10.2
TissueDopplerSVelocitySeptal (median [IQR]) 7.7 [6.8, 8.9] 8.0 [7.0, 9.0] 7.3 [6.4, 8.5] <0.001 13.7
TissueDopplerEVelositySeptal (median [IQR]) 7.9 [6.0, 9.8] 8.9 [7.0, 11.0] 7.0 [5.8, 8.3] <0.001 12.4
TissueDopplerEERatioSeptal (median [IQR]) 9.4 [7.7, 11.6] 8.6 [7.1, 10.5] 10.3 [8.4, 12.4] <0.001 13.3
TissueDopplerSVelocityLateral (median [IQR]) 9.0 [7.3, 10.5] 9.0 [7.9, 11.0] 8.4 [7.0, 10.0] <0.001 13.8
TissueDopplerEVelosityLateral (median [IQR]) 10.0 [8.0, 13.0] 11.6 [9.0, 14.5] 9.0 [7.0, 11.0] <0.001 12.7
TissueDopplerEERatioLateral (median [IQR]) 7.2 [5.7, 9.1] 6.5 [5.3, 8.1] 8.0 [6.4, 9.8] <0.001 13.6
Variables in univariate model for RVSP > 40
exp(coef) [confint] p
HTN 3.21 [2.92, 3.54] <0.001
age_by_10 1.56 [1.52, 1.61] <0.001
male 0.69 [0.63, 0.75] <0.001
BSA 0.65 [0.53, 0.79] <0.001
octogenarian1 3.99 [3.57, 4.45] <0.001
obese1 1.48 [1.33, 1.64] <0.001
overweight1 1.14 [1.04, 1.25] 0.005
LVESD 0.84 [0.76, 0.92] 0.001
LVEF 1.07 [1.06, 1.09] <0.001
LeftAtriumAPDiameter 1.13 [1.06, 1.23] 0.001
MitralInflowDecelerationTime 1.00 [1.00, 1.00] <0.001
TissueDopplerEVelositySeptal 0.93 [0.92, 0.95] <0.001
TissueDopplerEVelosityLateral 0.93 [0.92, 0.94] <0.001
TissueDopplerEERatioLateral 1.18 [1.16, 1.20] <0.001
LeftAtriumAPDiameter1 1.13 [1.06, 1.23] 0.001
IHD 1.19 [1.05, 1.34] 0.006
TissueDopplerEERatioSeptal 1.00 [1.00, 1.00] 0.001
Demographic and clinical features - Only HTN Patients
Overall RVSP <= 40 RVSP > 40 p Missing
n 13292 11468 1824
Age (median [IQR]) 66.00 [56.00, 75.00] 65.00 [55.00, 73.00] 73.00 [63.00, 81.00] <0.001 0.0
male = 1 (%) 6780 ( 51.0) 6052 ( 52.8) 728 ( 39.9) <0.001 0.0
octogenarian = 1 (%) 1751 ( 13.2) 1278 ( 11.1) 473 ( 25.9) <0.001 0.0
BSA (median [IQR]) 1.82 [1.68, 1.97] 1.83 [1.68, 1.97] 1.77 [1.63, 1.92] <0.001 7.8
BMI (median [IQR]) 26.12 [23.53, 29.40] 26.12 [23.60, 29.38] 26.13 [23.14, 30.12] 0.604 13.8
overweight = 1 (%) 6923 ( 60.4) 5979 ( 60.7) 944 ( 58.8) 0.162 13.8
obese = 1 (%) 2561 ( 22.3) 2147 ( 21.8) 414 ( 25.8) <0.001 13.8
DM = 1 (%) 2887 ( 21.7) 2424 ( 21.1) 463 ( 25.4) <0.001 0.0
IHD = 1 (%) 2403 ( 18.1) 2109 ( 18.4) 294 ( 16.1) 0.021 0.0
SystolicBloodPressure (median [IQR]) 133.00 [120.00, 148.00] 132.00 [120.00, 147.00] 135.00 [120.00, 151.00] <0.001 13.3
DiastolicBloodPressure (median [IQR]) 75.00 [67.00, 83.00] 76.00 [67.00, 84.00] 74.00 [64.00, 82.00] <0.001 13.4
RVSP (median [IQR]) 31.00 [27.00, 36.00] 30.00 [26.00, 34.00] 46.00 [43.00, 53.00] <0.001 0.0
LVEF (median [IQR]) 60.00 [60.00, 63.00] 60.00 [60.00, 60.00] 60.00 [60.00, 65.00] <0.001 13.8
LVEDD (median [IQR]) 4.40 [4.10, 4.70] 4.40 [4.10, 4.71] 4.30 [4.00, 4.68] <0.001 13.8
LVESD (median [IQR]) 2.66 [2.40, 2.97] 2.68 [2.40, 2.99] 2.60 [2.30, 2.90] <0.001 14.0
LeftVentricleInterventricularSeptumThickness (median [IQR]) 1.01 [0.90, 1.14] 1.00 [0.90, 1.13] 1.05 [0.92, 1.20] <0.001 1.0
LeftVentricleEstimatedMass (median [IQR]) 144.35 [119.00, 173.30] 144.35 [119.01, 172.72] 144.34 [118.58, 175.03] 0.945 2.2
LeftVentricleEstimatedMassIndex (median [IQR]) 79.00 [67.00, 93.00] 78.00 [67.00, 92.00] 82.00 [68.00, 97.00] <0.001 9.5
LeftAtriumAPDiameter (median [IQR]) 3.50 [3.24, 3.75] 3.50 [3.22, 3.70] 3.60 [3.30, 3.80] 0.003 2.3
AorticValveMeanPressureGradient (median [IQR]) 10.00 [7.57, 14.00] 10.00 [7.00, 13.00] 11.32 [9.00, 15.04] <0.001 92.5
AorticValveAreaContinuityEquation (median [IQR]) 1.58 [1.31, 1.84] 1.59 [1.31, 1.85] 1.57 [1.25, 1.81] 0.348 97.7
AorticValveMeanVelocity (median [IQR]) 141.00 [122.00, 167.00] 139.00 [121.00, 165.00] 151.92 [129.25, 179.65] <0.001 94.7
MitralInflowPeakEWave (median [IQR]) 70.70 [59.62, 83.84] 70.00 [59.00, 82.40] 77.00 [63.20, 94.94] <0.001 6.9
MitralInflowEARatio (median [IQR]) 0.88 [0.71, 1.15] 0.88 [0.71, 1.15] 0.88 [0.70, 1.17] 0.750 9.0
MitralInflowPeakAWave (median [IQR]) 78.00 [64.20, 92.80] 77.00 [63.90, 91.30] 85.00 [69.20, 101.00] <0.001 9.0
MitralInflowDecelerationTime (median [IQR]) 213.35 [179.00, 256.00] 215.00 [180.00, 256.00] 201.00 [165.00, 248.00] <0.001 10.0
TissueDopplerSVelocitySeptal (median [IQR]) 7.31 [6.39, 8.50] 7.33 [6.42, 8.48] 7.18 [6.00, 8.94] 0.465 13.8
TissueDopplerEVelositySeptal (median [IQR]) 7.00 [5.77, 8.30] 7.00 [5.77, 8.27] 7.00 [5.94, 8.69] 0.157 12.8
TissueDopplerEERatioSeptal (median [IQR]) 10.31 [8.42, 12.44] 10.21 [8.36, 12.30] 11.17 [8.96, 13.34] <0.001 13.9
TissueDopplerSVelocityLateral (median [IQR]) 8.38 [7.00, 10.00] 8.38 [7.00, 10.00] 8.40 [7.00, 10.00] 0.992 13.9
TissueDopplerEVelosityLateral (median [IQR]) 9.00 [7.02, 11.00] 9.00 [7.02, 11.00] 9.00 [7.10, 11.00] 0.895 13.3
TissueDopplerEERatioLateral (median [IQR]) 7.97 [6.42, 9.83] 7.86 [6.36, 9.68] 8.72 [7.00, 10.70] <0.001 14.3
LBBB = 0 (%) 13292 (100.0) 11468 (100.0) 1824 (100.0) NA 0.0
RBBB = 0 (%) 13292 (100.0) 11468 (100.0) 1824 (100.0) NA 0.0

Multivariate model for RVSP > 40

As contentious

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.00 [0.00, 0.00] <0.001
HTN 1.78 [1.56, 2.04] <0.001
age_by_10 1.42 [1.36, 1.47] <0.001
male 0.70 [0.62, 0.78] <0.001
obese1 1.29 [1.13, 1.47] <0.001
LVEF 1.03 [1.02, 1.05] <0.001
LeftAtriumAPDiameter 1.05 [0.96, 1.13] 0.221
TissueDopplerEERatioLateral 1.05 [1.03, 1.07] <0.001
IHD 0.73 [0.62, 0.86] <0.001

As Dichotomised

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.05, 0.06] <0.001
HTN 2.78 [2.45, 3.15] <0.001
octogenarian1 2.75 [2.39, 3.16] <0.001
male 0.64 [0.57, 0.72] <0.001
obese1 1.29 [1.13, 1.46] <0.001
la_diameter_large 1.31 [0.94, 1.78] 0.096
EeHigh 5.03 [2.50, 9.81] <0.001
IHD 0.77 [0.65, 0.91] 0.002

In Males

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.04 [0.03, 0.04] <0.001
HTN 2.38 [1.95, 2.91] <0.001
octogenarian1 3.07 [2.41, 3.88] <0.001
obese1 1.14 [0.91, 1.42] 0.252
la_diameter_large 1.60 [1.06, 2.32] 0.019
EeHigh 11.40 [4.39, 29.49] <0.001
IHD 0.69 [0.55, 0.86] 0.001

In Females

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.04, 0.05] <0.001
HTN 3.07 [2.62, 3.61] <0.001
octogenarian1 2.53 [2.13, 3.01] <0.001
obese1 1.37 [1.17, 1.60] <0.001
la_diameter_large 0.99 [0.56, 1.64] 0.957
EeHigh 2.02 [0.64, 5.41] 0.187
IHD 0.92 [0.72, 1.18] 0.528

In patients with abnormal la diameter or Ee’ ratio

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.11 [0.04, 0.22] <0.001
HTN 3.25 [1.63, 7.21] 0.002
octogenarian1 1.79 [1.00, 3.16] 0.046
male 0.77 [0.47, 1.28] 0.309
obese1 0.71 [0.43, 1.17] 0.187
IHD 0.90 [0.51, 1.55] 0.721

In patients with normal la diameter or Ee’ ratio

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.05, 0.06] <0.001
HTN 2.75 [2.42, 3.12] <0.001
octogenarian1 2.82 [2.44, 3.26] <0.001
male 0.63 [0.56, 0.70] <0.001
obese1 1.32 [1.16, 1.50] <0.001
IHD 0.76 [0.64, 0.91] 0.002

In octogenarians

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.18 [0.11, 0.27] <0.001
HTN 2.01 [1.31, 3.24] 0.002
male 0.68 [0.52, 0.89] 0.005
obese1 1.17 [0.83, 1.62] 0.370
la_diameter_large 0.77 [0.34, 1.54] 0.483
EeHigh 3.31 [0.90, 12.13] 0.062
IHD 1.19 [0.86, 1.63] 0.274

In non-octogenarians

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.04, 0.06] <0.001
HTN 2.87 [2.52, 3.27] <0.001
male 0.63 [0.56, 0.71] <0.001
obese1 1.31 [1.14, 1.50] <0.001
la_diameter_large 1.49 [1.04, 2.07] 0.025
EeHigh 5.65 [2.46, 12.21] <0.001
IHD 0.66 [0.54, 0.80] <0.001

In obese patients

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.07 [0.06, 0.09] <0.001
HTN 2.73 [2.06, 3.66] <0.001
octogenarian1 2.31 [1.65, 3.20] <0.001
male 0.55 [0.43, 0.70] <0.001
la_diameter_large 0.98 [0.57, 1.58] 0.929
EeHigh 4.10 [0.83, 16.49] 0.054
IHD 0.71 [0.49, 1.00] 0.056

In non-obese patients

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.04, 0.06] <0.001
HTN 2.77 [2.42, 3.19] <0.001
octogenarian1 2.84 [2.43, 3.31] <0.001
male 0.67 [0.59, 0.75] <0.001
la_diameter_large 1.66 [1.09, 2.45] 0.014
EeHigh 5.31 [2.39, 11.39] <0.001
IHD 0.79 [0.65, 0.95] 0.013

In patients with IHD

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.03, 0.09] <0.001
HTN 2.06 [1.24, 3.65] 0.008
octogenarian1 4.38 [3.09, 6.19] <0.001
male 0.50 [0.36, 0.69] <0.001
obese1 1.16 [0.78, 1.67] 0.454
la_diameter_large 2.08 [1.08, 3.74] 0.020
EeHigh 1.53 [0.21, 7.52] 0.629

In patients without IHD

Multivariate Model
exp(coef) [confint] p
(Intercept) 0.05 [0.04, 0.06] <0.001
HTN 2.85 [2.51, 3.24] <0.001
octogenarian1 2.51 [2.15, 2.93] <0.001
male 0.66 [0.59, 0.75] <0.001
obese1 1.32 [1.15, 1.50] <0.001
la_diameter_large 1.13 [0.77, 1.61] 0.522
EeHigh 6.43 [2.98, 13.50] <0.001