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Left ventricular hypertrophy detection and body mass index in essential hypertension

Cesare Cuspidi1, Valentina Giudici, Laura Lonati

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

Blood Pressure
|July 22, 2010
PubMed

Insights

Left ventricular hypertrophy (LVH) prevalence in hypertensive patients varies significantly based on how left ventricular mass (LVM) is indexed. Normalizing LVM to height(2.7) better identifies LVH in overweight/obese individuals, while normalization to body surface area (BSA) is more appropriate for lean/normal weight patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Criteria Evaluation

Background:

  • Left ventricular mass (LVM) is influenced by weight and height, key determinants in cardiovascular health.
  • The optimal method for normalizing LVM to assess left ventricular hypertrophy (LVH) in hypertensive patients remains a subject of debate.
  • Understanding LVH prevalence across different body mass index (BMI) categories is crucial for accurate risk stratification.

Purpose of the Study:

  • To compare the prevalence of LVH in hypertensive individuals using two distinct LVM indexation criteria.
  • To investigate how BMI influences the detection of LVH based on different normalization methods.
  • To determine the most appropriate indexation method for LVM across various BMI subgroups.

Main Methods:

  • A cohort of 4468 essential hypertensive patients was analyzed.
  • Patients were stratified into four BMI groups: lean (<20 kg/m²), normal (20-24.9 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²).
  • Left ventricular hypertrophy (LVH) was defined using two criteria: LVM indexed to body surface area (BSA) and LVM indexed to height(2.7).

Main Results:

  • Overall LVH prevalence was 44.9% by BSA indexation and 48.2% by height(2.7) indexation.
  • LVH prevalence increased with BMI across both indexation methods.
  • Height(2.7) indexation revealed higher LVH rates in overweight and obese groups compared to BSA indexation, while the opposite trend was observed in lean/normal weight groups.

Conclusions:

  • The choice of LVM indexation significantly impacts LVH prevalence estimates in hypertensive patients, particularly across different BMI categories.
  • Normalizing LVM to height(2.7) appears more sensitive for detecting LVH in overweight and obese individuals.
  • The study highlights the risk of underestimating LVH in specific BMI groups depending on the chosen indexation criterion, underscoring the need for BMI-specific diagnostic approaches.
Abstract

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