Sex-related Differences in Left Ventricular Geometry among Hypertensive Nigerians

INTRODUCTION: Understanding the differences in left ventricular (LV) geometry between sexes can improve hypertension management. This study examines whether sex differences influence variations in LV geometric patterns. MATERIALS AND METHODS: A cross-sectional analysis was conducted on 1,799 adults with essential hypertension from the Federal Medical Center Abuja Hypertension Registry between 2016 and 2021. Abnormal LV geometry using transthoracic echocardiography was defined as follows: Concentric LV remodeling as a normal LV mass index (LVMI) with relative wall thickness (RWT) >0.42, concentric LV hypertrophy (LVH) as increased LVMI (>95 g/m2 in females, >115 g/m2 in males) with RWT >0.42 and eccentric LVH as increased LVMI with RWT ≤0.42. RESULTS: The mean age of the study participants was 55.2 ± 13.0 years and the majority were females (55.9%). In total, more females had echocardiographic LVH (508, 50.5%) than males (345, 43.5%) (P = 0.003). More males (333, 42.0%) had concentric LV remodeling than females (355, 35.3%) (P = 0.004), while more females (352, 19.6%) had concentric LVH than males (220, 12.2%) (P < 0.001). There was no difference between the two sexes in eccentric LVH (P = 0.882). The predictors of concentric LVH among females were age (adjusted odds ratio [OR] =1.03, P < 0.001), diabetes mellitus (OR = 1.57, P = 0.007), and systolic blood pressure (OR = 1.01, P = 0.001). CONCLUSION: Our study showed an association between female sex and LVH within our hypertensive cohort. This finding suggests that females may be at a greater risk for cardiovascular morbidity and mortality compared to males.