Frequency of Moderate-to-Severe Left Ventricular Diastolic Dysfunction among Hypertensive Patients Attending a Tertiary Cardiac Centre: A Cross-Sectional Study from Peshawar

Abstract

Objective: To determine the frequency of moderate-to-severe (Grade II or III) left ventricular diastolic dysfunction among hypertensive patients attending a tertiary cardiac centre in Peshawar. Methodology: This analytical cross-sectional study included a total of 180 adult hypertensive patients aged 18–70 years were recruited. Patients with coronary artery disease, previous myocardial infarction, heart failure, atrial fibrillation, cardiomyopathy, congenital heart disease, chronic kidney disease, significant valvular heart disease, life-threatening systemic illness, or incomplete echocardiographic examinations were excluded. Transthoracic echocardiography was performed and left ventricular diastolic function was assessed, integrating mitral inflow velocities, tissue Doppler e′ velocity, average E/e′ ratio, tricuspid regurgitation velocity, and left atrial volume index for grading. Results: A total of 180 hypertensive patients were included in the final analysis. The mean age was 50.18 ± 10.71 years, and the mean duration of hypertension was 4.87 ± 2.75 years. Overall, 117 (65.0%) participants were aged ≥45 years, and 101 (56.1%) were male. Moderate-to-severe left ventricular diastolic dysfunction was identified in 66 patients, corresponding to a frequency of 36.7% (95% CI: 30.0%–43.9%). No statistically significant association was observed between moderate-to-severe diastolic dysfunction and age group (p=0.347), sex (p=0.763), marital status (p=0.343), educational status (p=0.513), occupation (p=0.259), or place of residence (p=0.536). Conclusion: Moderate-to-severe left ventricular diastolic dysfunction was present in more than one-third of hypertensive patients attending this tertiary cardiac centre. Routine echocardiographic assessment using standardized ASE/EACVI criteria may facilitate early identification of hypertensive individuals at increased risk of developing heart failure with preserved ejection fraction.