Left ventricular hypertrophy and mortality in hypertension: an analysis of data from the Glasgow Blood Pressure Clinic

Dunn, Francis G.; McLenachan, James M.; Isles, Chris; Brown, Ian; Dargie, H J; Lever, A. F.; Lorimer, A. R.; Murray, GD; Pringle, Steven D.; Robertson, James Louis

doi:10.1097/00004872-199008000-00012

Cited by 89 publications

(54 citation statements)

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“…23,24 Our own data show a direct association between a history of hypertension and sudden death after AMI. Therefore, ACE inhibition can also be of particular importance in hypertensives by inducing regression of pre-existing left ventricular hypertrophy and preventing the development of hypertrophy of the non-infarcted muscle as part of the remodelling process.…”

Section: Biological Plausibility: Reduction Of Infarct Expansion and mentioning

confidence: 69%

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

1999

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Background: After acute myocardial infarction (AMI), patients with a history of arterial hypertension (AH) have a worse prognosis than normotensives. Whether this adverse risk is beneficially modulated by treatment with angiotensin-converting enzyme (ACE) inhibitors is unknown. We evaluated the prognostic value of antecedent hypertension in post-AMI patients given ACE inhibitor therapy. Methods: We analysed retrospectively data from the AIRE study (randomised, placebo-controlled trial of ramipril in 2006 post-AMI patients with clinical heart failure). A history of AH was present in 28% of the patients. We examined the prognostic value of antecedent hypertension separately among placebo and ramipril treated patients and also the effect of ramipril on clinical outcomes according to whether or not a history of AH was present.

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Section: Biological Plausibility: Reduction Of Infarct Expansion and mentioning

confidence: 69%

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

1999

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“…Stroke 42 (9) 112 (4) 53 (6) 98 (4) CHD 44 (10) 189 (7) 120 (14) 258 (10) CVD 105 (21) 368 (13) 198 (23) 416 (17) Abbreviations: CHD, coronary heart disease; CVD, cardiovascular disease; LVH, left ventricular hypertrophy.…”

Section: Resultsmentioning

confidence: 99%

“…In a study of Swedish men, 11 the presence of LVH defined using the Cornell product independently predicted CVD and all cause mortality, whereas using SokolowLyon criteria, LVH only significantly predicted all cause mortality. In the study from the Glasgow Blood Pressure Clinic, 9 the presence of ECG LVH was diagnosed when the sum of SVI þ RV5 was above 35 mm or additionally the deepest precordial S and tallest R were above 40 mm. After adjustments, a significant increase in the risk of CHD and stroke mortality associated with the presence of ECG LVH was demonstrated among both hypertensive women and men.…”

Section: Discussionmentioning

confidence: 99%

“…3 Left ventricular hypertrophy has been shown to be associated with a significant increase in risk of cardiovascular mortality among the general population and hypertensive patients, independently of whether it is determined by electrocardiogram (ECG LVH), echocardiography (ECHO LVH) or radiology. 2,[4][5][6][7][8][9][10][11][12][13] Echocardiography is the gold standard for assessing anatomical LVH. 2,14 However, it is less readily available and sometimes difficult to perform in obese and elderly subjects.…”

Section: Introductionmentioning

confidence: 99%

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Left ventricular hypertrophy determined by Sokolow–Lyon criteria: a different predictor in women than in men?

et al. 2006

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The clinical usefulness of the Sokolow-Lyon voltage criteria in the assessment of electrocardiographic left ventricular hypertrophy (ECG LVH) is addressed. We prospectively studied 3338 women and 3330 men referred with hypertension, with an average follow-up of 11.2 years. The voltage amplitude sum SV1 þ max (RV5 or RV6) was calculated and ECG LVH was defined as a sum X3.5 mV. We adjusted survival for age, treatment status before presentation and a previous myocardial infarction or cerebrovascular accident. The risk of stroke, coronary heart disease (CHD) and cardiovascular disease (CVD) mortality increased significantly for each quantitative 0.1 mV increase in baseline electrocardiogram (ECG) voltage, in women within the range of 1.6-3.9% and in men 1.4-3.0%. After further adjustments for race, body mass index, smoking and systolic blood pressure, increasing voltage independently predicted CVD mortality in both men and women. In women, both increasing voltage and the presence of left ventricular hypertrophy (LVH) were predictors of stroke mortality, whereas in men this risk was attenuated. In men, the adjusted association between increasing voltage and CHD mortality tended to be stronger than in women. The use of different thresholds for the two genders made little difference. For stroke and CHD mortality, the population attributable fractions associated with LVH were 15.2 and 5.4% in women and 12.8 and 8.5% in men, respectively. In conclusion, the greater the baseline ECG voltage sum, the greater the associated CVD mortality risk. Women tended to have a high risk of stroke mortality owing to LVH despite adjustments.

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“…This is similar to the prevalence reported by others. [24][25][26][27] We then addressed whether differences in factors associated with LVH existed in those with LVH vs those without, with particular attention to components of the RAAS. In individuals with LVH, the most striking observation was a lower PRA level under low sodium conditions and higher aldosterone levels on a high sodium conditions.…”

Section: Discussionmentioning

confidence: 99%

Influence of dietary sodium on the renin–angiotensin–aldosterone system and prevalence of left ventricular hypertrophy by EKG criteria

Williams

Jeunemaı̂tre

et al. 2004

J Hum Hypertens

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We investigated the interplay of dietary sodium and renin-angiotensin-aldosterone system (RAAS) activity with the prevalence of left ventricular hypertrophy (LVH) in essential hypertension. Electrocardiograms (EKG) were reviewed for the presence of LVH in 160 hypertensive patients. We then compared the rate of LVH to levels of plasma renin activity (PRA) and serum aldosterone under high and low sodium diet conditions. On high sodium diet, serum aldosterone was significantly higher (7.770.93 vs 5.770.35 ng/dl, P ¼ 0.02) in participants with LVH. With low sodium diet and upright posture, PRA was significantly lower in subjects with LVH vs those without (5.671.1 vs 7.670.56 ng/ml/h, P ¼ 0.026). Aldosterone levels on low sodium diet were not different between those with and those without LVH. PRA was then dichotomized at the lowest quartile under low sodium/upright posture conditions to define a 'low renin' group. In a multivariate logistic regression containing renin status (low renin vs normal/high renin), aldosterone on a high sodium diet, age, body mass index, gender, race, duration of hypertension, systolic and diastolic blood pressure and salt-sensitivity only low-renin status on a low sodium diet (P ¼ 0.019) and serum aldosterone on a high sodium diet (P ¼ 0.04) were significant predictors of LVH. Thus, reduced modulation of renin activity in response to sodium restriction and an increased aldosterone on a high sodium diet appear to identify characteristics of hypertensive patients predisposed to abnormal cardiac remodelling.

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Left ventricular hypertrophy and mortality in hypertension: an analysis of data from the Glasgow Blood Pressure Clinic

Cited by 89 publications

References 0 publications

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

Left ventricular hypertrophy determined by Sokolow–Lyon criteria: a different predictor in women than in men?

Influence of dietary sodium on the renin–angiotensin–aldosterone system and prevalence of left ventricular hypertrophy by EKG criteria

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