Year: 2025 | Month: December | Volume: 12 | Issue: 12 | Pages: 826-836
DOI: https://doi.org/10.52403/ijrr.20251283
Alteration of Echocardiographic Parameters in Adults with Prehypertension: A Systematic Review
Oliver Chikwado Nweze1, Christopher C. Ohagwu1, Victor K. Nwodo1, Emmanuel Emeka Ezugwu1, Sharonrose Ogochukwu1, Sunday Chukwudi Agbo1, Omeji Emmanuel Ifeanyi1, Odo Obed Chukwunonyelum2
1Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria
2Department of Medical Radiography, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
Corresponding Author: Oliver Chikwado Nweze
ABSTRACT
Background: Prehypertension, defined as systolic blood pressure 120–139 mmHg or diastolic blood pressure 80–89 mmHg, is associated with increased cardiovascular risk. Subclinical cardiac remodeling, including structural, geometric, and functional alterations, may occur before the onset of overt hypertension.
Aim: To synthesize current evidence on echocardiographic changes in prehypertensive adults across diverse populations.
Materials and Methods: A systematic review was conducted using studies published in English language between 2010 and 2025, reporting echocardiographic parameters in prehypertensive adults compared with normotensive controls. Databases searched included PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Findings were qualitatively synthesized due to heterogeneity in study designs and echocardiographic methods.
Results: Fourteen studies encompassing populations from Europe, Asia, Africa, and the USA were included, predominantly cross-sectional, with two longitudinal cohorts. Prehypertensive individuals consistently exhibited higher LV mass and LV mass index, modestly increased wall thickness, and early concentric geometric remodeling. Subclinical systolic dysfunction, detected by strain imaging, was observed despite preserved conventional ejection fraction. LVH prevalence ranged from 2–7% in most populations, with higher rates in African cohorts. Age, sex, body mass index, metabolic factors, and systolic blood pressure were associated with structural and functional alterations.
Conclusion: Prehypertension is associated with early structural and functional cardiac changes detectable by echocardiography, emphasizing that it is not a benign condition. Early identification of these alterations provides an opportunity for risk stratification and preventive interventions. Future longitudinal studies with standardized echocardiographic protocols and broader population representation are warranted to clarify progression patterns and guide clinical management.
Keywords: Echocardiography, Prehypertension; Left ventricular mass; LV geometry; Strain imaging; Subclinical cardiac remodeling
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