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Published on: April 30, 2020

Left ventricular hypertrophy by Sokolow-Lyon voltage criterion predicts mortality in overweight hypertensive subjects

R L Antikainen1, T Grodzicki, D G Beevers

  • 1Care of the Elderly, Division of Medicine, Imperial College, London, UK. r.antikainen@imperial.ac.uk

Journal of Human Hypertension
|August 30, 2008
PubMed

Insights

Electrocardiogram (ECG) left ventricular hypertrophy (LVH) is less sensitive in overweight individuals but remains a significant predictor of mortality. Despite lower sensitivity, ECG-detected LVH in overweight patients signals increased cardiovascular risk.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • Sokolow-Lyon voltage criteria for electrocardiographic left ventricular hypertrophy (ECG LVH) exhibit low sensitivity in overweight individuals.
  • Hypertension management and cardiovascular risk stratification are critical public health concerns.

Purpose of the Study:

  • To determine the clinical utility of Sokolow-Lyon voltage criteria for assessing ECG LVH in both lean and overweight hypertensive subjects.
  • To evaluate the predictive value of ECG LVH for cardiovascular outcomes in different body mass index (BMI) categories.

Main Methods:

  • Prospective follow-up of 1840 lean and 3555 overweight hypertensive subjects over 11 years.
  • ECG LVH assessed using Sokolow-Lyon criterion (SV1 + max(RV5, RV6) ≥ 3.5 mV).
  • Overweight defined as BMI ≥ 25 kg/m²; statistical adjustments for age, sex, smoking, glucose, and cholesterol.

Main Results:

  • Prevalence of ECG LVH was lower in overweight (12-20%) compared to lean (16-35%) subjects.
  • Increased ECG voltage significantly predicted stroke, coronary heart disease, and cardiovascular disease (CVD) mortality in both lean and overweight groups.
  • This predictive value persisted in overweight subjects after adjusting for other risk factors, particularly evident in women with higher BMI.

Conclusions:

  • Despite lower sensitivity in overweight individuals, ECG LVH detected by Sokolow-Lyon criteria is a valuable predictor of mortality.
  • Overweight hypertensive patients with ECG LVH face a significantly elevated risk of cardiovascular events and death.
  • ECG LVH assessment remains clinically relevant for risk stratification across diverse BMI ranges in hypertensive populations.

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