Association of Electrocardiographic Left Ventricular Hypertrophy with Future Renal Function Decline in the General Population

Background Electrocardiographic left ventricular hypertrophy (LVH) could predict adverse renal outcome in patients with hypertension. This study aimed to investigate the association between electrocardiographic LVH and future decline of renal function in the general population. Methods This retrospective cohort study included individuals who received population-based health checkups from 2010 to 2019 in Japan. Electrocardiographic LVH was defined according to the Minnesota code. Renal function decline was defined as a decrease of ≥25% in the estimated glomerular filtration rate from baseline to <60 mL/min/1.73 m 2 . Multivariate adjusted Cox regression analysis was employed to evaluate the association between electrocardiographic LVH at baseline and renal function decline. Results Of the 19,825 study participants, 1,263 exhibited electrocardiographic LVH at the baseline visit. The mean follow-up period was 3.4 ± 1.9 years. The incidence rates of renal function decline were 0.30 and 0.78 per 100 person-years in the non-LVH group and LVH groups, respectively. Electrocardiographic LVH was associated with the risk for renal function decline in both unadjusted analysis (hazard ratio 2.50, 95% confidence interval 1.73–3.60, P < 0.001) and adjusted analysis (hazard ratio 1.69, 95% confidence interval 1.14–2.50, P = 0.009). This association was comparable across subgroups stratified by age, sex, body mass index, diagnosed hypertension, systolic blood pressure, hemoglobin A1c, and urinary protein. Conclusions In the general population, electrocardiographic LVH was associated with future renal function decline. To detect high-risk individuals for renal function decline, electrocardiographic LVH may be useful in the setting of health checkups in the general population. Clinical Perspectives What is new? This longitudinal study using a population-based annual health checkup data revealed that electrocardiographic LVH was associated with future renal function decline in the general population. The association between electrocardiographic LVH and future renal function decline was consistent regardless of individual characteristics. What are the clinical implications? Renal dysfunction is a risk factor for cardiovascular disease and death as well as renal failure. This study shows the prognostic value of electrocardiographic LVH to predict future renal dysfunction in the general population under annual health checkups. Individuals with electrocardiographic LVH may require careful follow-up to prevent and detect the progression of renal dysfunction even if they do not have hypertension.