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Improving cardiovascular risk stratification in essential hypertensive patients by indexing left ventricular mass to

Cesare Cuspidi1, Valentina Giudici, Francesca Negri

  • 1Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Italy. cesare.cuspidi@unimib.it

Journal of Hypertension
|November 10, 2009
PubMed

Insights

Left ventricular hypertrophy (LVH) identified solely by height indexed left ventricular mass (LVM) in hypertensive patients indicates an unhealthy metabolic profile and organ damage. Routine indexing to both BSA and height is recommended for better cardiovascular risk assessment.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Left ventricular hypertrophy (LVH) is a significant cardiovascular risk factor.
  • Defining LVH solely by left ventricular mass (LVM) indexed to height(2.7) has unclear clinical implications.
  • Essential hypertensive patients require better risk stratification for subclinical organ damage.

Purpose of the Study:

  • To investigate the prevalence of LVH defined by LVM indexed to height(2.7) only.
  • To identify clinical correlates and extracardiac organ damage in this specific hypertensive patient group.
  • To assess the utility of dual indexing criteria for LVM in cardiovascular risk stratification.

Main Methods:

  • A cohort of 3719 hypertensive patients (untreated and treated) was analyzed.
  • LVH was assessed using two criteria: LVM indexed to height(2.7) and LVM indexed to body surface area (BSA).
  • Patients were categorized based on LVH presence by one, both, or neither criterion.

Main Results:

  • A significant proportion of patients had LVH by height(2.7) indexing but not BSA indexing.
  • This group (LVH by height(2.7) only) exhibited a higher prevalence of obesity, metabolic syndrome, and female sex.
  • Intermediate levels of extracardiac organ damage (carotid changes, microalbuminuria, retinal changes) were observed in this group.

Conclusions:

  • LVH defined by LVM indexed to height(2.7) alone identifies hypertensive patients with adverse metabolic profiles and subclinical organ damage.
  • Routine indexing of LVM to both BSA and height(2.7) is crucial for comprehensive cardiovascular risk assessment.
  • Categorizing patients based on consistent LVH criteria improves stratification of cardiovascular risk.
Abstract

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