Left ventricular hypertrophy reduction and clinical events. A meta-regression analysis of 14 studies in 12,809 hypertensive patients

Pierluigi Costanzo, Gianluigi Savarese, Giuseppe Rosano, Francesca Musella, Laura Casaretti, Enrico Vassallo, Stefania Paolillo, Fabio Marsico, Giuseppe Rengo, Dario Leosco, Pasquale Perrone-Filardi

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Left ventricular hypertrophy (LVH) is an independent risk factor for clinical events (CE), and regression of LVH is associated with reduction of cardiovascular risk. However, whether a continuous relationship between reduction of LVH and risk of CE exists has not been investigated. Methods: Randomized clinical trials evaluating LVH at baseline and reporting quantitative LVH changes and CE, stroke or new onset heart failure) were included. Meta-regression analysis was performed to test the relationship between changes in LVH and incidence of the composite outcome (all-cause death, MI, stroke or new onset heart failure) and between changes of LVH and occurrence of each component of the composite outcome. Analysis of potential confounder variables was also performed. Results: Fourteen trials including 12,809 participants and reporting 2259 events were included. Follow-up ranged from 0.50 to 5 years, with mean 1.97 ± 1.50 years. Mean age was 62 ± 5 years and 52% of patients were women. The composite outcome was significantly reduced by active treatments (OR: 0.851, IC: 0.780 to 0.929, p <0.001), as well stroke (OR: 0.756, IC: 0.638 to 0.895, p <0.001) whereas MI and new onset heart failure were not significantly reduced by treatments. LVH changes did not predict the reduction of CE. No significant influence on the association of baseline patients and studies characteristics was found. Conclusions: A significant continuous relationship between LVH changes and CE could not be demonstrated in hypertensive patients, independently on the technique or drug used. Ad hoc designed studies should further explore the relationship between LVH modification and outcomes in hypertensive patients.

Original languageEnglish
Pages (from-to)2757-2764
Number of pages8
JournalInternational Journal of Cardiology
Volume167
Issue number6
DOIs
Publication statusPublished - 2013

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Left Ventricular Hypertrophy
Meta-Analysis
Regression Analysis
Heart Failure
Stroke
Risk Reduction Behavior
Cause of Death
Randomized Controlled Trials
Incidence

Keywords

  • Cardiovascular risk
  • Left ventricular hypertrophy
  • Meta-analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Left ventricular hypertrophy reduction and clinical events. A meta-regression analysis of 14 studies in 12,809 hypertensive patients. / Costanzo, Pierluigi; Savarese, Gianluigi; Rosano, Giuseppe; Musella, Francesca; Casaretti, Laura; Vassallo, Enrico; Paolillo, Stefania; Marsico, Fabio; Rengo, Giuseppe; Leosco, Dario; Perrone-Filardi, Pasquale.

In: International Journal of Cardiology, Vol. 167, No. 6, 2013, p. 2757-2764.

Research output: Contribution to journalArticle

Costanzo, Pierluigi ; Savarese, Gianluigi ; Rosano, Giuseppe ; Musella, Francesca ; Casaretti, Laura ; Vassallo, Enrico ; Paolillo, Stefania ; Marsico, Fabio ; Rengo, Giuseppe ; Leosco, Dario ; Perrone-Filardi, Pasquale. / Left ventricular hypertrophy reduction and clinical events. A meta-regression analysis of 14 studies in 12,809 hypertensive patients. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 6. pp. 2757-2764.
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T1 - Left ventricular hypertrophy reduction and clinical events. A meta-regression analysis of 14 studies in 12,809 hypertensive patients

AU - Costanzo, Pierluigi

AU - Savarese, Gianluigi

AU - Rosano, Giuseppe

AU - Musella, Francesca

AU - Casaretti, Laura

AU - Vassallo, Enrico

AU - Paolillo, Stefania

AU - Marsico, Fabio

AU - Rengo, Giuseppe

AU - Leosco, Dario

AU - Perrone-Filardi, Pasquale

PY - 2013

Y1 - 2013

N2 - Background: Left ventricular hypertrophy (LVH) is an independent risk factor for clinical events (CE), and regression of LVH is associated with reduction of cardiovascular risk. However, whether a continuous relationship between reduction of LVH and risk of CE exists has not been investigated. Methods: Randomized clinical trials evaluating LVH at baseline and reporting quantitative LVH changes and CE, stroke or new onset heart failure) were included. Meta-regression analysis was performed to test the relationship between changes in LVH and incidence of the composite outcome (all-cause death, MI, stroke or new onset heart failure) and between changes of LVH and occurrence of each component of the composite outcome. Analysis of potential confounder variables was also performed. Results: Fourteen trials including 12,809 participants and reporting 2259 events were included. Follow-up ranged from 0.50 to 5 years, with mean 1.97 ± 1.50 years. Mean age was 62 ± 5 years and 52% of patients were women. The composite outcome was significantly reduced by active treatments (OR: 0.851, IC: 0.780 to 0.929, p <0.001), as well stroke (OR: 0.756, IC: 0.638 to 0.895, p <0.001) whereas MI and new onset heart failure were not significantly reduced by treatments. LVH changes did not predict the reduction of CE. No significant influence on the association of baseline patients and studies characteristics was found. Conclusions: A significant continuous relationship between LVH changes and CE could not be demonstrated in hypertensive patients, independently on the technique or drug used. Ad hoc designed studies should further explore the relationship between LVH modification and outcomes in hypertensive patients.

AB - Background: Left ventricular hypertrophy (LVH) is an independent risk factor for clinical events (CE), and regression of LVH is associated with reduction of cardiovascular risk. However, whether a continuous relationship between reduction of LVH and risk of CE exists has not been investigated. Methods: Randomized clinical trials evaluating LVH at baseline and reporting quantitative LVH changes and CE, stroke or new onset heart failure) were included. Meta-regression analysis was performed to test the relationship between changes in LVH and incidence of the composite outcome (all-cause death, MI, stroke or new onset heart failure) and between changes of LVH and occurrence of each component of the composite outcome. Analysis of potential confounder variables was also performed. Results: Fourteen trials including 12,809 participants and reporting 2259 events were included. Follow-up ranged from 0.50 to 5 years, with mean 1.97 ± 1.50 years. Mean age was 62 ± 5 years and 52% of patients were women. The composite outcome was significantly reduced by active treatments (OR: 0.851, IC: 0.780 to 0.929, p <0.001), as well stroke (OR: 0.756, IC: 0.638 to 0.895, p <0.001) whereas MI and new onset heart failure were not significantly reduced by treatments. LVH changes did not predict the reduction of CE. No significant influence on the association of baseline patients and studies characteristics was found. Conclusions: A significant continuous relationship between LVH changes and CE could not be demonstrated in hypertensive patients, independently on the technique or drug used. Ad hoc designed studies should further explore the relationship between LVH modification and outcomes in hypertensive patients.

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KW - Left ventricular hypertrophy

KW - Meta-analysis

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