Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

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Background: Electrocardiography (ECG) has low sensitivity for detecting left ventricular hypertrophy (LVH), whileechocardiography cannot be routinely performed.Design/methods: In this study we evaluate the prevalence of LVH and diastolic dysfunction in hypertensive patientswith normal ECG. We excluded patients with cardiovascular (CV) diseases, diabetes, chronic kidney disease, or presentingECG-LVH or other ECG anomalies. The enrolled 440 hypertensive patients underwent echocardiographicexamination (Acuson Sequoia 512); LV mass was indexed by body surface area (LVMI) and LVH was defined as LVMI>125 g/m2 in men and >110 g/m2 in women. Diastolic function was evaluated by mitral inflow and tissue Doppler imaging(TDI).Results: The prevalence of LVH was 8.18% (95% confidence interval [CI] 5.97–11.1%). Multiple regression analysisshowed that the only variable independently associated with LVH was duration of hypertension (p<0.001). The receiveroperating characteristic (ROC) curve showed that duration of hypertension was a powerful predictor of LVH, with anarea under the curve (AUC) of 0.878 and p<0.0001. Further, in patients with LVH the mean difference of LVMI from thecut-off value for LVH was 12.3 9.19 g/m2. Diastolic dysfunction, defined as early diastolic myocardial velocity (Em)<0.08 m/s, was detected only in 3.2% of patients.Conclusions: The prevalence of LVH among hypertensive patients with normal ECG, free of diabetes and of CVdiseases is low; moreover, patients with echocardiographic LVH presented LVMI values that identified mild LVH. Fewcases of impaired diastolic function were registered.We suggest that in hypertensive patients with such characteristics the echocardiographic examination should be reservedto those who present with higher duration of hypertension.
Lingua originaleEnglish
pagine (da-a)854-861
Numero di pagine8
RivistaEuropean Journal of Preventive Cardiology
Stato di pubblicazionePublished - 2013

All Science Journal Classification (ASJC) codes

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