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Association of electrocardiographic left ventricular hypertrophy with incident cardiovascular disease in Japanese older hypertensive patients.

Publication ,  Journal Article
Edison, ES; Yano, Y; Hoshide, S; Kario, K
Published in: Am J Hypertens
April 2015

BACKGROUND: Our aim was to assess whether electrocardiographic left ventricular hypertrophy (ECG-LVH) is associated with a higher risk of cardiovascular disease (CVD) events, independent of 24-hour blood pressure (BP) and circulating levels of norepinephrine and hemostatic factors. METHODS: In 514 older hypertensive patients (mean age 72.3 years; 37% men), we assessed ambulatory BP values, circulating levels of norepinephrine and hemostatic factors (plasma fibrinogen, prothrombin fragment 1+2 (F1+2), von Willebrand factor (vWF), and plasminogen activator inhibitor-1 (PAI-1)), and the presence or absence of ECG-LVH (Sokolow-Lyon voltage ≥ 3.5 mV). The incidence of CVD events (i.e., myocardial infarction and stroke) was prospectively ascertained. RESULTS: During an average 41 months of follow-up (1,751 person-years), 43 stroke and 3 myocardial infarction events occurred. At baseline, patients with ECG-LVH had higher mean 24-hour BP (148.8/83.8mm Hg vs. 135.7/77.2mm Hg) and circulating norepinephrine levels (404.6 pg/ml vs. 336.3 pg/ml) compared to those without ECG-LVH; the differences remained unchanged after adjustment for age, gender, smoking status, presence of diabetes, and antihypertensive medication uses at follow-up time (all P < 0.01). Cox proportional hazards models suggested that the hazard ratio (HR; 95% confidence interval (CI)) of CVD events for those with ECG-LVH was 4.4 (2.3-8.2), and the association between ECG-LVH and incident CVD events remained significant after adjustment for high 24-hour BP (≥130/80mm Hg), nocturnal SBP, circulating norepinephrine and fibrinogen levels (HRs, 3.5-4.2, all P < 0.001). CONCLUSIONS: In older hypertensive patients, ECG-LVH was associated with a higher risk of CVD events, independent of ambulatory BP parameters and circulating norepinephrine and fibrinogen levels.

Duke Scholars

Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

April 2015

Volume

28

Issue

4

Start / End Page

527 / 534

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Predictive Value of Tests
  • Norepinephrine
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Japan
 

Citation

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Edison, E. S., Yano, Y., Hoshide, S., & Kario, K. (2015). Association of electrocardiographic left ventricular hypertrophy with incident cardiovascular disease in Japanese older hypertensive patients. Am J Hypertens, 28(4), 527–534. https://doi.org/10.1093/ajh/hpu184
Edison, Eijiro Sugiyama, Yuichiro Yano, Satoshi Hoshide, and Kazuomi Kario. “Association of electrocardiographic left ventricular hypertrophy with incident cardiovascular disease in Japanese older hypertensive patients.Am J Hypertens 28, no. 4 (April 2015): 527–34. https://doi.org/10.1093/ajh/hpu184.
Edison, Eijiro Sugiyama, et al. “Association of electrocardiographic left ventricular hypertrophy with incident cardiovascular disease in Japanese older hypertensive patients.Am J Hypertens, vol. 28, no. 4, Apr. 2015, pp. 527–34. Pubmed, doi:10.1093/ajh/hpu184.
Journal cover image

Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

April 2015

Volume

28

Issue

4

Start / End Page

527 / 534

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Predictive Value of Tests
  • Norepinephrine
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Japan