Value of electrocardiographic left ventricular hypertrophy as a predictor of poor blood pressure control

Abstract

Recent studies have shown that hypertension is poorly controlled in many populations worldwide. Electrocardiographic left ventricular hypertrophy is a common manifestation of preclinical cardiovascular disease that strongly predicts cardiovascular disease morbidity and mortality. However, little information is available regarding the role of left ventricular hypertrophy in blood pressure (BP) control. We aimed to assess the relationship between electrocardiographic left ventricular hypertrophy and BP control in the China Stroke Primary Prevention Trial. The study population included 17,312 hypertensive patients who were selected from a group of 20,702 adults who had participated in the China Stroke Primary Prevention Trial and had undergone electrocardiography at baseline visit. Multivariate analysis identified left ventricular hypertrophy as a predictor of unsatisfactory BP control. The results revealed that 8.1% of hypertensive adults exhibit left ventricular hypertrophy and that the disease is more prevalent in males (12.8%) than in females. Multivariate regression analysis showed that the electrocardiographic left ventricular hypertrophy group had a significantly higher rate of unsatisfactory BP control [odds ratio (OR) 1.42, 95% confidence interval (95% CI) 1.26–1.61, P < .001) than the nonleft ventricular hypertrophy group.Notable differences in BP control were also observed among males (OR 1.37, 95% CI 1.17–1.60, P < .001) and females (OR 1.45, 95% CI 1.18–1.77, P < .001) and especially among patients with comorbid diabetes (OR 2.32, 95% CI 1.31–4.12, P = .004). In conclusion, the results of this study indicate that electrocardiographic left ventricular hypertrophy appears to be an independent predictive factor for poor BP control, especially in females and patients with comorbid diabetes.

New data from a subanalysis of the TRICOLOR study: antihypertensive effectiveness of the triple single-pill combination of amlodipine/indapamide/perindopril and predictors of effectiveness and blood pressure control in young patients

“…Имеются ограниченные научные данные о взаимосвязи ГЛЖ и контроля АД. Так, в наблюдательном исследовании China Stroke Primary Prevention Trial [19] у 17312 китайских пациентов с АГ показано, что в группе пациентов с наличием электрокардиографических признаков ГЛЖ отмечалась значимо большая частота неудовлетворительного контроля АД (ОШ 1,42; 95% ДИ: 1,26-1,61, р<0,001), по сравнению с группой с отсутствием ГЛЖ, что согласуется с нашими результатами, полученными в группе молодых пациентов.…”

Inhibition of the STIM1/Orai1 Signaling Pathway by Glycine Betaine Mitigates Myocardial Hypertrophy in Spontaneous Hypertension Rats

“…Primary hypertension, also known as spontaneous hypertension, is a cardiovascular syndrome with elevated systemic arterial pressure as the main clinical manifestation. Poor longterm blood pressure control will lead to corresponding changes in the heart structure, that is, left ventricular hypertrophy [1]. Left ventricular hypertrophy increases the risk of myocardial ischemia, sudden cardiac death, heart failure, arrhythmia, and other cardiovascular diseases in hypertensive patients [2].…”