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Hypertension and ECG-LVH and CV Mortality

Am J Cardiol; ePub 2018 Oct 18; Cao, et al

The inability of electrocardiographic left ventricular hypertrophy (ECG-LVH) to explain the association between hypertension and cardiovascular disease (CVD) mortality suggests that LVH is only 1 of many factors by which hypertension exerts its impact on CVD. In this study, researchers examined the interrelationship between hypertension, ECG-LVH, and CVD mortality in 6,105 individuals free of CVD who were followed for a median of 14 years. They found:

  • ECG-LVH prevalence exponentially increases as systolic blood pressure (SBP) increases.
  • Hypertension was associated with more than double the risk of ECG-LVH, and each standard-deviation increase in SBP was associated with 49% increased odds of ECG-LVH (OR, 1.49).
  • In separate Cox models, both ECG-LVH and hypertension were associated with CVD mortality.
  • However, when ECG-LVH and hypertension were entered together in the same model, the risk of CVD mortality was essentially unchanged for hypertension after adjusting for ECG-LVH, but markedly attenuated for ECG-LVH after adjusting for hypertension.

Citation:

Cao X, Broughton ST, Waits GS, Nguyen T, Li Y, Soliman EZ. Interrelations between hypertension and electrocardiographic left ventricular hypertrophy and their associations with cardiovascular mortality. [Published online ahead of print October 18, 2018]. Am J Cardiol. doi:10.1016/j.amjcard.2018.10.006.