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[Left ventricular hypertrophy in hypertension]
M A Ghanem Wisam1, J Murin, J Bulas
11st Dpt of Internal Medicine FN, Mickiewiczova 13, SK-813 69 Bratislava 1, Slovakia. wisam.ghanem@usa.net
Insights
Left ventricular hypertrophy (LVH) in hypertensive patients is linked to more cardiovascular complications like heart failure and kidney issues. Early detection of LVH in hypertension is recommended to manage the disease course.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Left ventricular hypertrophy (LVH) is a known complication of hypertension.
- Other atherosclerosis risk factors like hyperlipidemia and smoking can worsen hypertension prognosis.
- The study investigates clinical differences in hypertensive patients with and without LVH.
Purpose of the Study:
- To compare clinical findings in hypertensive patients with and without echocardiographically defined LVH.
- To assess the impact of LVH on cardiovascular complications in hypertension.
- To evaluate the prognostic significance of LVH in hypertensive individuals.
Main Methods:
- Retrospective analysis of 185 hypertensive patients' hospital records (1996-1999).
- LVH defined by echocardiography (Penn convention): LV mass index > 134 g/m2 (men), > 110 g/m2 (women).
- Patients matched for demographics, hyperlipidemia, and smoking; diabetes and obesity excluded.
Main Results:
- LVH present in 109 patients (mean age 66.7 years), absent in 76 (mean age 64.7 years).
- Statistically significant higher incidence of heart failure, myocardial infarction, renal failure, and mitral regurgitation in LVH-positive patients.
- Stroke incidence was slightly higher in LVH-negative patients.
Conclusions:
- Hypertensive patients with LVH experience a more complicated disease course.
- LVH is a significant complicating factor in arterial hypertension.
- Routine examination for LVH in hypertensive patients is recommended for better disease management.
Abstract:
Left ventricular hypertrophy LVH is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Occurrence of other risk factors of atherosclerosis in these hypertensive patients such as hyperlipidemia and smoking deteriorate the prognosis too. The authors compared clinical findings in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 185 hypertensive patients treated at our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 109 patients (mean age 66.7 years), absence of LVH in 76 patients (mean age 64.7 years). Both groups of hypertensive patients were matched by demographic parameters by the presence of hyperlipidemia and by smoking habits. Hypertensive patients with diabetes mellitus and obesity were excluded. They were statistically significant in the incidence of heart failure, myocardial infarction, renal failure and mitral regurgitation, and non-significant in the incidence of left ventricular diastolic dysfunction. There were more cardiovascular complications in LVH-positive patients than in those with LVH-negative findings. The incidence of stroke was slightly higher in LVH-negative patients. Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease. The authors recommend to examine the patients with arterial hypertension for the presence of left ventricular hypertrophy as it complicates the course of the disease significantly. (Tab. 3, Fig. 2, Ref. 26.)