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[Is left ventricular hypertrophy in hypertension a marker for coronary risk factors?]
1Kardiologisk seksjon, Medisinsk avdeling, Vestfold sentralsykehus, Tønsberg.
Insights
Left ventricular hypertrophy (LVH) affects 44% of men with hypertension. While LVH correlates with higher blood pressure, it doesn't indicate other coronary risk factors in asymptomatic individuals.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Context:
- Mild to moderate hypertension is common, and its subclinical cardiovascular effects require investigation.
- Asymptomatic individuals with hypertension may harbor underlying cardiac changes.
- Understanding these changes is crucial for risk stratification and management.
Purpose:
- To investigate the prevalence of left ventricular hypertrophy (LVH) in asymptomatic men with mild to moderate hypertension.
- To assess the relationship between LVH and exercise-induced ischemia.
- To determine if LVH is associated with other coronary risk factors in this population.
Summary:
- Echocardiography revealed LVH in 38 (44%) of 86 asymptomatic men with hypertension.
- Silent ischemia was rare, observed in only two patients during maximal exercise.
- Men with LVH exhibited significantly higher systolic blood pressure at rest and during exercise.
- Lipid profiles, smoking prevalence, and lipoprotein/apoprotein concentrations did not differ between groups with and without LVH.
Impact:
- LVH is a prevalent finding in asymptomatic hypertensive men.
- Elevated blood pressure is the primary correlate of LVH in this cohort.
- LVH, in the absence of other factors, may not serve as an independent marker for additional coronary risks.
- Findings emphasize the importance of blood pressure control in preventing cardiac remodeling.
Abstract:
86 asymptomatic men with mild to moderate hypertension were examined by echocardiography, exercise ECG and measurements of their lipid profile. Left ventricular hypertrophy, defined as an increased left ventricular mass index > or = 130 g/m2, was found in 38 (44%) patients. Only two men showed evidence of silent ischemia during maximum exercise. The men with left ventricular hypertrophy had a higher systolic blood pressure at rest (p = 0.0002), at submaximal (p = 0.02) and maximal exercise (p = 0.01). The prevalence of smokers was the same, as were the concentrations of lipids, lipoproteins and apoproteins in the two groups. Except for a higher blood pressure, left ventricular hypertrophy is not a special marker for other coronary risk factors.