Left Ventricular Hypertrophy is a predictor of cardiovascular events in elderly hypertensives: hypertension in the the very elderly trial (HYVET)

Rajkumar, Chakravarthi, Antikainen, Riitta L, Peters, Ruth, Beckett, Nigel S, Fagard, Robert H, Wang, Ji-Guang and Bulpitt, Christopher J (2016) Left Ventricular Hypertrophy is a predictor of cardiovascular events in elderly hypertensives: hypertension in the the very elderly trial (HYVET). Journal of Hypertension, 34 (11). pp. 2280-2286. ISSN 0263-6352

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Abstract

Objective: We assessed the prognostic value of electrocardiographic left ventricular hypertrophy (LVH) using Sokolow-Lyon (SL-LVH), Cornell Voltage (CV-LVH) or Cornell Product (CP-LVH) Criteria in 3043 hypertensive people aged 80 years and over enrolled in the Hypertension in the Very Elderly Trial.

Methods: Multivariate Cox proportional hazard models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for all-cause mortality, cardiovascular diseases, stroke and heart failure in participants with and without LVH at baseline. The mean follow-up was 2.1 years.

Results: LVH identified by CV- or CP-LVH Criteria was associated with a 1.6 to 1.9-fold risk of cardiovascular disease and stroke. The presence of CP-LVH was associated with an increased risk of heart failure (HR 2.38, 95% CL 1.16-4.86). In gender specific analyses, CV-LVH (HR 1.94, 95%Cl 1.06-3.55) and CP-LVH (HR 2.36, 95% CI 1.25-4.45) were associated with an increased risk of stroke in women and of heart failure in men, CV-LVH (HR 6.47, 95 % Cl 1.41-29.79) and CP-LVH (10.63, 95Cl % 3.58-31.57), respectively. There was no significant increase in the risk of any outcomes associated with SL LVH. LVH identified by these three methods was not a significant predictor of all-cause mortality.

Conclusions: Use of Cornell Voltage and Cornell Product criteria for LVH predicted the risk of cardiovascular disease and stroke. Only Cornell Product was associated with an increased the risk of heart failure. This was particularly the case in men. The identification of electrocardiographic LVH proved to be important in very elderly hypertensive people.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Clinical and Experimental Medicine
Depositing User: Marie Shelton
Date Deposited: 01 Aug 2016 10:49
Last Modified: 20 Sep 2017 11:05
URI: http://sro.sussex.ac.uk/id/eprint/62166

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