Prevalence of electrocardiographic left ventricular hypertrophy in human hypertension

Cuspidi, Cesare; Rescaldani, Marta; Sala, Carla; Negri, Francesca; Grassı, Guıdo; Mancia, Giuseppe

doi:10.1097/hjh.0b013e32835726a3

Cited by 64 publications

(37 citation statements)

References 44 publications

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“…A recent systematic review of 40 444 treated and untreated hypertensive patients found the prevalence of LVH on ECG to be 18%. [19] Our average prevalence of 49.1% is far higher, suggesting either that our population is inherently at higher risk of LVH or, more plausibly, that there are a greater number of patients with undetected and uncontrolled hypertension in our population. National hypertension work groups and guidelines have advocated for a long time that more resources be allocated to the early detection and management of hypertension in SA communities to prevent the onset of TOD.…”

Section: Discussionmentioning

confidence: 74%

Evaluation and management of patients referred to a tertiary-level hypertension clinic in Cape Town, South Africa

2016

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Background. Hypertension remains a global health burden, with a high incidence of long-term morbidity and mortality. Objectives. To evaluate blood pressure (BP) control, factors associated with poor BP control, target organ damage (TOD), white-coat hypertension, treatment-resistant hypertension and secondary hypertension in patients referred to a tertiary-level hypertension clinic. Method. This was a prospective case-control study of patients referred for specialist hypertension management. Patient parameters recorded included age, gender, body mass index, uric acid, cholesterol, screening BP, follow-up BP, TOD and medications. We also recorded causes of secondary hypertension. Net BP change and the percentage achieving target BP were calculated in all patients followed up. Results. A total of 175 patients were sampled (72 males and 103 females, mean age 46.5 years). Of the patients 16.6% had a normal screening BP; 62.9% of patients were followed up, and 43.6% of these achieved BP control. After intervention, there was a net drop of 13.2 mmHg (range 7.9 -18.4) in systolic BP and of 3.8 mmHg (4.4 -12.0) in diastolic BP. Of all the patients, 12.6% had resistant hypertension, 49.1% had evidence of left ventricular hypertrophy and 18.3% had microalbuminuria; 13.1% of the patients were diagnosed with secondary hypertension. Conclusion. Specialist intervention was useful in identifying patients with white-coat and secondary hypertension, as well as in improving hypertension control in patients with apparent treatment-resistant hypertension. However, a significant percentage of patients did not reach target BP, and further efforts are required to identify the underlying causes for this.

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Section: Discussionmentioning

confidence: 74%

Evaluation and management of patients referred to a tertiary-level hypertension clinic in Cape Town, South Africa

2016

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“…For example, LVH detected with standard ECG is a strong independent predictor of myocardial infarction, stroke, congestive heart failure and sudden cardiac death [19,20], and is associated with a poor prognosis in very old men and women [21]. Its prevalence is highly influenced by the criteria used [22]. In the present study, the prevalence of LVH criteria was similar to other studies, but slightly higher than the prevalence observed in the Bambuí cohort of elderly patients from Bambuí city, from the same province in Brazil, which ECGs were codified by the Annex Publishers | www.annexpublishers.com Volume 3 | Issue 2…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic Abnormalities in the Elderly: A Study in a Large Database of Primary Care Patients

Marcolino¹,

Ga²,

Al³

2017

Journal of Clinical and Experimental Research in Cardiology

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“…It has long been known that there is an association between blood pressure and lV mass 15 . It is also known that hypertension in patients with initially asymptomatic mild to moderate aortic stenosis is associated with a more abnormal lV structure, as well as with increased cardiovascular morbidity and mortality 16 .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with left ventricular hypertrophy in adults with surgically repaired coarctation of the aorta

Rinnström¹,

Johansson²

2015

ICFJ

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Introduction: Most patients with repaired coarctation of the aorta (CoA) live normal lives and have good physical performance. However, even after a successful surgical intervention, long-term cardiovascular risks including left ventricular hypertrophy remain. The aim of the study was to identify factors associated with increased left ventricular mass (LVM) in patients with surgically repaired CoA. Methods: Consecutive cardiovascular magnetic resonance investigations in 51 patients with surgically repaired CoA (age 37+/-15 years, age at intervention 9.7 ± 6.8 years, 45% female) were reviewed. LVM was measured and indexed to body surface area. The association between increased LVM index and clinical, anatomic and functional variables was investigated with logistic regression analysis. Results: In this population, 14/51 (27%) patients had a LVM index above normal limits. Factors associated with an increased LVM index in univariate analysis were higher systolic blood pressure (odds ratio (OR) = 1.04, 95 % confidence interval (CI) 1.00-1.08, p = 0.03), descending aortic diameter (OR = 1.48, CI 1.14-1.90, p = 0.003) and more than mild aortic valve disease or previous aortic valve intervention (OR = 15.1, CI 2.50-48.4, p=0.002), but not diastolic blood pressure, diameter of ascending aorta, diameter or ratio of CoA, velocity in descending aorta, smoking or bicuspid aortic valve (p > 0.05 for all). In multivariate analysis, only systolic blood pressure (p = 0.05) and aortic valve disease (p = 0.006) remained significant, yielding R2 = 0.47, p = 0.002 for the model. Conclusion: Increased LVM is a common late finding after surgically repaired CoA. This study showed that LVM was associated with modifiable factors; systolic blood pressure and aortic valve disease. As most patients are young, and increased LVM will eventually affect ventricular function, close attention to blood pressure optimization may be of particular importance in the surgically repaired CoA population.

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Prevalence of electrocardiographic left ventricular hypertrophy in human hypertension

Abstract: Our analysis shows that LVH, as assessed by ECG, is present in a relevant fraction of the hypertensive population; these data highlight the role of ECG as a first-line examination for identifying subclinical organ damage and optimizing blood pressure control in hypertensive patients.

Cited by 64 publications

References 44 publications

Evaluation and management of patients referred to a tertiary-level hypertension clinic in Cape Town, South Africa

Evaluation and management of patients referred to a tertiary-level hypertension clinic in Cape Town, South Africa

Electrocardiographic Abnormalities in the Elderly: A Study in a Large Database of Primary Care Patients

Factors associated with left ventricular hypertrophy in adults with surgically repaired coarctation of the aorta

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