Association of CVAI, age, and clinic systolic blood pressure with left ventricular hypertrophy in postmenopausal women with primary hypertension: A single-centre retrospective case–control study

Objective This study aimed to evaluate the associations of the Chinese Visceral Adiposity Index (CVAI), age, and clinic systolic blood pressure (SBP) with left ventricular hypertrophy (LVH) in postmenopausal women with primary hypertension. Methods We conducted a retrospective case-control study including 501 postmenopausal women hospitalized with primary hypertension between January and December 2023 at the Department of Hypertension at the Fifth Affiliated Hospital of Xinjiang Medical University. Participants were divided into an LVH group (cases, n=86) and a non-LVH group (controls, n=415) based on the left ventricular mass index (LVMI). Clinical data, biochemical parameters, echocardiographic results, and the CVAI were collected. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to determine the association between LVH and the outcome. Results Compared to the non-LVH group, the LVH group exhibited significantly higher age, clinical SBP, proportion of coronary artery disease, blood urea nitrogen (BUN) levels, CVAI, and cystatin C levels (all P<0.05). Left ventricular geometric patterns also differed significantly between the two groups (P < 0.001). Multivariate logistic regression analysis identified CVAI (odds ratio OR =1.025, 95% confidence interval CI = 1.013–1.038), age (OR=1.045, 95% CI = 1.013–1.079), and clinical SBP (OR=1.020, 95% CI = 1.007–1.033) as independent risk factors for LVH. Multinomial logistic regression showed that CVAI was associated with concentric (OR = 1.026, 95% CI = 1.008–1.044) and eccentric hypertrophy (OR = 1.026, 95% CI = 1.011–1.041). The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.702 for CVAI alone, with a sensitivity of 83.7% and a specificity of 48%. The discriminative performance of CVAI was significantly better than that of the ventricular artery index (VAI; 0.551) and left anterior portal (LAP; 0.575). The combined discrimination using all three factors (CVAI, age, and clinical SBP) yielded an AUC of 0.751. Conclusion CVAI, age, and clinical SBP are independent risk factors for LVH in postmenopausal women with primary hypertension.