Left ventricular hypertrophy is a predictor of cardiovascular events in elderly hypertensive patients

Antikaínen, Riitta; Peters, Ruth; Beckett, Nigel; Fagard, Robert; Wang, Ji‐Guang; Rajkumar, Chakravarthi; Bulpitt, Christopher J.

doi:10.1097/hjh.0000000000001073

Cited by 30 publications

(27 citation statements)

References 39 publications

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“…Of which, 40 articles were removed for various reasons. Thus, nine studies involving 41 870 hypertensive patients satisfied our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies 7,[10][11][12]17,18 reported the association between electrocardiographic LVH and all-cause mortality. Comparison with those with and without LVH patients (Figure 2), the pooled RR was 1.30 (95% CI 1.01-1.66; I 2 = 33.0%; P = .214) for Sokolow-Lyon voltage criteria, 7,12,17 1.33 (95% CI 1.20-1.47; I 2 = 0.0%; P = .467) for Cornell voltage criteria 10-12,17 and 1.31 (95% CI 0.97-1.78; I 2 = 51.8%; P = .150) for Cornell product criteria.…”

Section: All-cause Mortalitymentioning

confidence: 99%

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Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Zhang

Wei

2020

J of Clinical Hypertension

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Electrocardiographic left ventricular hypertrophy (LVH) has been used to predict adverse outcomes in different clinical settings. This meta‐analysis aimed to compare the prognostic value of different electrocardiographic criteria of LVH at baseline in hypertensive patients. A systematic literature search was conducted in PubMed and Embase databases until December 3, 2019. Cohort studies that reported the association of baseline electrocardiographic LVH (Sokolow‐Lyon voltage, Cornell voltage or Cornell product) with all‐cause mortality or major cardiovascular events in hypertensive patients were included. The prognostic value of LVH was expressed by the risk ratio (RR) with 95% confidence interval (CI). Nine studies involving 41 870 hypertensive patients were identified. Comparison with those with and without LVH patients indicated that the pooled RR value of all‐cause mortality was 1.30 (95% CI 1.01‐1.66) for the Sokolow‐Lyon voltage criteria, 1.33 (95% CI 1.20‐1.47) for the Cornell voltage criteria, and 1.31 (95% CI 0.97‐1.78) for the Cornell product criteria. In addition, the pooled RR of major cardiovascular events was 1.53 (95% CI 1.27‐1.86) for the Sokolow‐Lyon criteria and 1.46 (95% CI 1.22‐1.76) for the Cornell voltage criteria, respectively. This meta‐analysis suggests that different electrocardiographic criteria for detecting LVH at baseline differ in prediction of all‐cause mortality in patients with hypertension. LVH detected by the Cornell voltage and Sokolow‐Lyon criteria can independently predict the major cardiovascular events in hypertensive patients.

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“…Of which, 40 articles were removed for various reasons. Thus, nine studies involving 41 870 hypertensive patients satisfied our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Section: All-cause Mortalitymentioning

confidence: 99%

Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Zhang

Wei

2020

J of Clinical Hypertension

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“…Left ventricular hypertrophy (LVH) is found in 36%‐41% of patients with hypertension and predicts cardiovascular events (CVEs) and total mortality independently of traditional risk . LVH carries an increased risk of 1.6‐ to 3.5‐fold for CVEs, cardiovascular deaths, and total mortality, and an 8‐fold risk for congestive heart failure (CHF) . Among hypertensive patients, LVH contributes to about 30% of all deaths, 25% of CVEs, and 75% of CHF .…”

Section: Introductionmentioning

confidence: 99%

Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium‐sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta‐analysis

Roush

Abdelfattah

Song

et al. 2018

J of Clinical Hypertension

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Left ventricular hypertrophy develops in 36%‐41% of hypertensive patients and independently predicts cardiovascular events and total mortality. Moreover, drug‐induced reduction in left ventricular mass (LVM) correlates with improved prognosis. The optimal thiazide‐type diuretic for reducing LVM is unknown. Evidence regarding potency, cardiovascular events, sodium, and potassium suggested the hypothesis that “CHIP” diuretics (CHlorthalidone, Indapamide, and Potassium‐sparing diuretic/hydrochlorothiazide [PSD/HCTZ]) would reduce LVM more than HCTZ. Systematic searches of five databases were conducted. Among the 38 randomized trials, a 1% reduction in systolic blood pressure (SBP) predicted a 1% reduction in LVM, P = 0.00001. CHIP‐HCTZ differences in reducing LVM differed across trials (ie, heterogeneity), making interpretation uncertain. However, among the 28 double‐blind trials, heterogeneity was undetectable, and HCTZ reduced LVM (percent reduction [95% CI]) by −7.3 (−10.4, −4.2), P < 0.0001. CHIP diuretics surpassed HCTZ in reducing LVM: chlorthalidone −8.2 (−14.7, −1.6), P = 0.015; indapamide −7.5 (−12.7, −2.3), P = 0.005; and all CHIP diuretics combined −7.7 (−12.2, −3.1), P < 0.001. The comparison of PSD/HCTZ with HCTZ had low statistical power but favored PSD/HCTZ: −6.0 (−14.1, +2.1), P = 0.149. Thus, compared to HCTZ, CHIP diuretics had twice the effect on LVM. CHIP diuretics did not surpass HCTZ in reducing systolic or diastolic blood pressure: −0.3 (−5.0, +4.3) and −1.6 (−5.6, +2.4), respectively. The strength of evidence that CHIP diuretics surpass HCTZ for reducing LVM was high (GRADE criteria). In conclusion, these novel results have demonstrated that CHIP diuretics reduce LVM 2‐fold more than HCTZ among hypertensive patients. Although generally related to LVM, blood pressure fails to explain the superiority of CHIP diuretics for reducing LVM.

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“…LEFT VENTRICULAR (LV) hypertrophy occurs in about 10-15% of the general adult population (87) and in~40% of hypertensive patients (18) and is a predictor of adverse cardiovascular events, including heart failure and death, in hypertensive patients (1,49,65). It is therefore important to understand the mechanism(s) that cause hypertrophy.…”

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confidence: 99%

How does pressure overload cause cardiac hypertrophy and dysfunction? High-ouabain affinity cardiac Na⁺pumps are crucial

Blaustein

2017

American Journal of Physiology-Heart and Circulatory Physiology

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Left ventricular hypertrophy is frequently observed in hypertensive patients and is believed to be due to the pressure overload and cardiomyocyte stretch. Three recent reports on mice with genetically engineered Na pumps, however, have demonstrated that cardiac ouabain-sensitive α-Na pumps play a key role in the pathogenesis of transaortic constriction-induced hypertrophy. Hypertrophy was delayed/attenuated in mice with mutant, ouabain-resistant α-Na pumps and in mice with cardiac-selective knockout or transgenic overexpression of α-Na pumps. The latter, seemingly paradoxical, findings can be explained by comparing the numbers of available (ouabain-free) high-affinity (α) ouabain-binding sites in wild-type, knockout, and transgenic hearts. Conversely, hypertrophy was accelerated in α-ouabain-resistant (R) mice in which the normally ouabain-resistant α-Na pumps were mutated to an ouabain-sensitive (S) form (αα or "SWAP" vs. wild-type or α α mice). Furthermore, transaortic constriction-induced hypertrophy in SWAP mice was prevented/reversed by immunoneutralizing circulating endogenous ouabain (EO). These findings show that EO and its receptor, ouabain-sensitive α, are critical factors in pressure overload-induced cardiac hypertrophy. This complements reports linking elevated plasma EO to hypertension, cardiac hypertrophy, and failure in humans and elucidates the underappreciated role of the EO-Na pump pathway in cardiovascular disease.

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Left ventricular hypertrophy is a predictor of cardiovascular events in elderly hypertensive patients

Cited by 30 publications

References 39 publications

Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium‐sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta‐analysis

How does pressure overload cause cardiac hypertrophy and dysfunction? High-ouabain affinity cardiac Na⁺pumps are crucial

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Left ventricular hypertrophy is a predictor of cardiovascular events in elderly hypertensive patients

Cited by 30 publications

References 39 publications

Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Prognostic value of left ventricular hypertrophy in hypertensive patients: A meta‐analysis of electrocardiographic studies

Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium‐sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta‐analysis

How does pressure overload cause cardiac hypertrophy and dysfunction? High-ouabain affinity cardiac Na+pumps are crucial

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How does pressure overload cause cardiac hypertrophy and dysfunction? High-ouabain affinity cardiac Na⁺pumps are crucial