الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Prehypertension is commonly prevalent in the general population but there are only few studies on the prevalence and risk factors available. Prolonged elevation of BP commonly leads to a variety of changes in myocardial structure, coronary vasculature, and conduction system of the heart, creeping into development of left ventricular hypertrophy (LVH), (CAD), angina, myocardial infarction (MI), cardiac arrhythmias, and congestive heart failure (CHF) We aimed to: study the impact of gray zone hypertension on left ventricular structure, geometry and function. This study Included all asymptomatic healthy subjects who visited the OPD for their routine health checkup. But those with any history of recent surgeries, diabetes mellitus, congenital heart disease, rheumatic heart disease, unstable or stable angina, valvular heart disease, pericardial disease and hypertrophic cardiomyopathy which were based on the echocardiographic findings, congestive heart failure, respiratory disease, kidney disease and thyroid dysfunction were excluded . Then the studied group were classified into two groups: group A included (50) subjects whose blood pressure in gray zone hypertension [SBP from 120-139] & [DBP from 80-89] group B included (50) subjects with SBP<120 mmHg & DBP < 80 mmHg ❖ Methods: After taking consent and history, general and local examination, resting ECG and measurement of blood pressure according to latest guidelines was done. Echocardiographic evaluation: measurements were taken for LV dimension and function, LV mass was calculated and indexed for (BSA) and relative wall thickness. Also optimum views were taken for speckle tracking to calculate global longitudinal strain. The data were collected and analyzed using specific programs. ❖ Results and conclusion: Our overall findings showed that grey zone hypertension affects the left ventricular geometry and that diastolic dysfunction appears to be significantly associated with pre HT in apparently healthy population. As diastolic dysfunction is an important pathophysiological intermediate between HT and heart failure, preventive strategies are necessary to reduce morbidity in pre hypertensive subjects who show a risk for diastolic dysfunction. There is no effect on systolic function when calculated by conventional method to calculate FS& EF, but when using dedicated method e.g. 2D speckle tracking echocardiography to calculate the (GLS) there were significant difference between two groups., however no marked abnormalities in absolute value., but GLS of pre hypertensive group shows value less than that for control group , which indicate that prehypertension may have subtle effect on systolic function . Also LVISD, LVM, LVMI were raised in pre hypertensive males & females with significant difference between the two groups, p value less than 0.001., these may be due to early stage of hyper dynamic circulation & LV wall stress. Pre hypertensive stage when detected early, the preventive and curative aspects of treatment therefore, might be initiated to reduce the cardiovascular risk factors. In such cases, regular physical exercise, modification of diet, yoga and relaxation therapy, low salt intake and overall life style modification are essential and to be judiciously followed to avoid further cardiovascular and renal complications.