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Prevalence and predictors of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram

Emilio Nardi1, Alessandro Palermo, Giuseppe Mulè

  • 1Dipartimento di Medicina Interna e Specialistica (DIMIS), Excellence Centre of the European Society of Hypertension, Università degli Studi di Palermo, Italy.

European Journal of Preventive Cardiology
|May 5, 2012
PubMed

Insights

Left ventricular hypertrophy (LVH) is uncommon in hypertensive patients with normal electrocardiograms (ECG) and no other diseases. Longer hypertension duration predicts LVH, suggesting targeted echocardiography for these patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Electrocardiography (ECG) exhibits limited sensitivity for detecting left ventricular hypertrophy (LVH).
  • Echocardiography, while effective, is not routinely performed for LVH screening.

Purpose of the Study:

  • To determine the prevalence of LVH and diastolic dysfunction in hypertensive patients with normal ECG.
  • To identify predictors of LVH in this specific patient cohort.

Main Methods:

  • 440 hypertensive patients without cardiovascular disease, diabetes, or kidney disease were enrolled.
  • Echocardiography was used to assess LV mass indexed by body surface area (LVMI) and diastolic function.
  • LVH was defined as LVMI >125 g/m² (men) or >110 g/m² (women).

Main Results:

  • The prevalence of LVH was 8.18% in patients with normal ECG.
  • Hypertension duration was the sole independent predictor of LVH (p < 0.001), with an AUC of 0.878.
  • Diastolic dysfunction was detected in only 3.2% of patients.

Conclusions:

  • LVH prevalence is low in hypertensive patients without comorbidities and normal ECG.
  • Patients with echocardiographic LVH had mild elevations in LVMI.
  • Echocardiography may be best reserved for hypertensive patients with longer disease duration.
Abstract

Keywords:
Left ventricular hypertrophyechocardiographyelectrocardiographyhypertension

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