Left ventricular hypertrophy detection and body mass index in essential hypertension
Source: Blood Pressure, Volume 19, Number 6, December 2010 , pp. 337-343(7)
Publisher: Informa Healthcare
Background and aim. Weight and height are two major determinants of left ventricular mass (LVM); the anthropometric parameter to which LVM should be normalized remains, however, debated. In a population of hypertensives, we compared the prevalence of left ventricular hypertrophy (LVH) defined by two indexation criteria of LVM in different subgroups of body mass index (BMI). Methods. A total of 4468 essential hypertensives included in the Evaluation of Target Organ Damage in Hypertension (ETODH), were divided in four groups according to BMI thresholds: lean (BMI<20 kg/m2, 4.5%), normal (20–24.9 kg/m2, 36.5%), overweight (25–29.9 kg/m2, 41.9%) and obese (≥30 kg/m2, 17.1%). All patients underwent quantitative echocardiography; LVH was defined by two criteria of LVM indexation: (A) ≥116 g/m2 in men and ≥96 g/m2 in women; (B) ≥49 g/m2.7 in men and ≥45 g/m2.7 in women. Results. Overall, 44.9% of the patients were found to have LVH by criterion A, 48.2% by criterion B and 37.0% by both criteria. Prevalence rates of LVH in the four BMI groups were 34.3%, 40.5%, 47.3%, 53.9% by criterion A, 19.8%, 37.0%, 53.6%, 69.7% by criterion B, and 14.2%, 30.9%, 41.5%, 47.8% by both criteria, respectively (p at least <0.05 for all). Conclusions. Our findings show that LVH prevalence in both overweight and obese hypertensives is higher when LVM is normalized to height2.7 compared with body surface area (BSA), whereas the opposite trend occurs in normal weight/lean hypertensives. Thus, the risk related to LVH is underestimated when the LVH/height2.7 criterion is applied to lean/normal weight individuals and the LVH/BSA criterion in overweight/obese individuals.
Document Type: Research Article
Affiliations: 1: Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano 2: Istituto Auxologico Italiano, Milano 3: Thoraco-Pulmonary and Cardiocirculatory Department, University of Milano, Fondazione Ospedale Maggiore Policlinico, Milano
Publication date: December 1, 2010