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Prevalence and severity of echocardiographic left ventricular hypertrophy in hypertensive patients in clinical
Cesare Cuspidi1, Francesca Negri, Maria Lorenza Muiesan
1Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy. cesare.cuspidi@unimib.it
Insights
Left ventricular hypertrophy (LVH) is highly prevalent in hypertensive patients, even with treatment. This study found significant LVH in a large clinical cohort, highlighting the need for continued management strategies.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Limited data exists on left ventricular hypertrophy (LVH) prevalence in clinical practice for hypertension.
- Previous studies primarily focused on population-based or selected hypertensive cohorts.
- This study addresses the gap by examining LVH in a large, routine clinical sample.
Purpose of the Study:
- To determine the prevalence of LVH in hypertensive patients undergoing routine echocardiography.
- To assess the severity of LVH in this clinical population.
- To provide insights into LVH burden in everyday hypertension management.
Main Methods:
- A multicentre study included 2249 hypertensive patients referred for echocardiography.
- LVH was defined using three established criteria based on left ventricular mass.
- LVH severity was graded as mild, moderate, or severe.
Main Results:
- LVH prevalence ranged from 58% to 65% across the different criteria.
- Mild LVH was observed in 29-33% of patients.
- Moderate LVH affected 27-31%, and severe LVH was present in 36-44%.
Conclusions:
- Left ventricular hypertrophy is a frequent finding in hypertensive patients, even those receiving treatment.
- A substantial proportion of hypertensive patients exhibit severe LVH.
- These findings underscore the persistent challenge of LVH in hypertension management.
Background And Aim:
The prevalence of left ventricular hypertrophy (LVH) in human hypertension has been mostly documented in population-based samples and selected hypertensive cohorts. Rather scant data are available from clinical practice. Thus, we examined the prevalence of LVH in a large group of hypertensive patients referred by general practitioners to a routine echocardiographic examination.
Methods:
A total of 2249 hypertensive subjects (mean age 62 years, 52.3% men, 84.5% treated) referred by their practitioners to 17 outpatient echocardiographic laboratories across Italy for detection of hypertensive early cardiac damage were included in the study. LVH was defined as left ventricular mass (A) ≥ 225/163 g, (B) ≥ 116/96 g/m(2), (C) ≥ 49/45 g/m(2.7) in men/women, respectively; LVH was graded as mild, moderate and severe according to Lang's report.
Results:
Overall, patients with LVH were 58%, 58% and 65% by criteria A, B and C, respectively. LVH was mild in 33% (A), 36% (B) and 29% (C), moderate in 31% (A), 28% (B) and 27% (C), and severe in 36% (A), 36% (B) and 44% (C).
Conclusions:
Data provided by this multicentre nationwide survey support the view that, despite therapeutic interventions, LVH remains a highly frequent phenotype in human hypertension and that severe LVH is present in a large fraction of hypertensives.
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