Left ventricular hypertrophy assessed by Cornell product was a significant predictor of stroke in a Japanese general population (HR 1.62; 95% CI 1.19 to 2.20; P=0.002).
Cohort (n=10,755)
Does ECG-assessed left ventricular hypertrophy predict stroke and myocardial infarction in a general population including normotensive and prehypertensive subjects?
ECG-assessed left ventricular hypertrophy, particularly by Cornell product, is a strong predictor of stroke even in normotensive and prehypertensive individuals.
Hazard Ratio: 1.62 (95% CI 1.19–2.2)
p-value: p=0.002
Left ventricular hypertrophy (LVH), assessed by ECG, is associated with an increased risk for cardiovascular events among hypertensive subjects. We evaluated the risks of LVH in a Japanese general population including normotensive and prehypertensive subjects. We measured ECG and blood pressure in 10 755 subjects at baseline. The Cornell product (CP) and Sokolow-Lyon (SL) voltage were calculated as markers of LVH (CP >or=2440 mm x ms and SL voltage >or=38 mm). Follow-up was performed for 10 years, and the incidence of stroke and myocardial infarction was evaluated. The prevalence of CP-LVH was 2.7% for normotensives, 5.2% for prehypertensives, and 11.0% for hypertensives, and the prevalence of SL-LVH was 5.0%, 8.2%, and 15.2%, respectively. In all of the subjects, CP-LVH and SL-LVH were both predictors of stroke (CP-LVH: hazard risk: 1.62, 95% CI: 1.19 to 2.20, P=0.002; SL-LVH: hazard risk: 1.29, 95% CI: 0.98 to 1.71, P=0.07) after adjustment for confounding factors but were not predictors of myocardial infarction. The adjusted hazard ratio of CP-LVH predicting stroke was especially high in the normotensives (hazard risk: 7.53; 95% CI: 3.39 to 16.77). In the normotensives, diabetes mellitus and hyperlipidemia were significant determinants of CP-LVH but not of SL-LVH. In all of the hypertensive subgroups (normotensives, prehypertensives, and hypertensives), the c-statistic for the equation predicting stroke increased when CP-LVH was added to the model but not when SL-LVH was added. In conclusion, both CP-LVH and SL-LVH are risk factors for stroke in the Japanese general population. CP-LVH is related to glucose abnormality, and its predictive value for stroke is seen even in normotensives and prehypertensives.
Ishikawa et al. (Tue,) conducted a cohort in Left ventricular hypertrophy (n=10,755). Left ventricular hypertrophy (CP-LVH) vs. Absence of LVH was evaluated on Incidence of stroke (HR 1.62, 95% CI 1.19 to 2.20, p=0.002). Left ventricular hypertrophy assessed by Cornell product was a significant predictor of stroke in a Japanese general population (HR 1.62; 95% CI 1.19 to 2.20; P=0.002).