Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values

Michele Bombelli, Rita Facchetti, Stefano Carugo, Fabiana Madotto, Francesca Arenare, Fosca Quarti-Trevano, Anna Capra, Cristina Giannattasio, Raffaella Dell'Oro, Guido Grassi, Roberto Sega, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: Previous studies have shown that left ventricular hypertrophy (LVH) represents a cardiovascular risk factor independently of clinic blood pressure (BP). The present study was aimed at determining the impact of LVH on the incidence of cardiovascular morbid and fatal events taking into account not only classical risk factors but also home and ambulatory BP values, which have been shown to have an important independent prognostic impact. METHODS: In 1716 patients belonging to the ĝ€Pressioni Arteriose Monitorate E Loro Associazioniĝ€™ population of Monza, we quantified left ventricular mass index and identified LVH by standard cutoff values. We also measured clinic, home and 24-h ambulatory BPs together with serum glucose and lipids. RESULTS: During a follow-up of 148 months, the rate of fatal and nonfatal (hospitalizations) cardiovascular events as well as of all-cause death was markedly greater (four-fold to five-fold) in patients as compared with those without LVH. In LVH individuals, the increased risk remained significant even when data were adjusted for a large number of other confounding factors including home BP, 24-h mean BP and ambulatory BP. Results were similar when left ventricular mass was indexed by height and body surface area. A 10% increase in left ventricular mass index was associated with a significant increase in cardiovascular risk or all-cause deaths. In multivariate analysis, left ventricular mass index was always an independent predictor of cardiovascular events and death for any cause. CONCLUSION: Our data provide evidence that LVH is an important risk factor even when the contribution of different BPs to risk is fully taken into account.

Original languageEnglish
Pages (from-to)2458-2464
Number of pages7
JournalJournal of Hypertension
Volume27
Issue number12
DOIs
Publication statusPublished - Dec 2009

Keywords

  • Ambulatory blood pressure
  • Cardiovascular risk
  • Home blood pressure
  • Left ventricular hypertrophy

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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