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.
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.
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Antihypertensive Medications and Thrombolysis Therapy, J Clin Hypertens; ePub 2019 Jan 23; Fleming, et al
Admission BP & Outcomes in Patients with TIA, Am J Cardiol; ePub 2019 Jan 11; Bangalore, et al