Left Ventricular Mass Index: A Predictor of Morbidity and Mortality in Essential Hypertension

BACKGROUND: Hypertension is one of the leading causes of the global burden of disease and is the most important health problem met by general physicians. The development of left ventricular hypertrophy increases with the severity and duration of hypertension and presence of increased left ventricular mass is associated with increased incidence of other target organ damage. Early detection and appropriate treatment decreases the development of increased left ventricular mass index and reduces the mortality and morbidity.AIM OF STUDY: To establish the correlation of increased left ventricular mass index with target organ involvement in hypertensive patients.METHOD: 50 patients of both sexes with essential hypertension attending the outpatient clinic as well as those admitted in medical wards at Sri Adichunchanagiri Institute of Medical Science and Research Centre, B.G. Nagara from November 2010 to April 2012 were involved in the study. 2D echocardiography was performed for all subjects and left ventricular mass index was calculated for each. STATISTICAL TESTS: 1. Kappa measurement of agreement 2. Chi-square test. RESULTS: Out of 50 patients, 22 had increased left ventricular mass index, by echocardiogram. Target organ damage in the form of Retinopathy was found in 90.9% (p<0.01), nephropathy in 13.6%, TIA/stroke in 22.7% and cardiac failure in 22.7% of patients with increased left ventricular mass index. Whereas among patients with normal left ventricular mass index, 46.4% had retinopathy, 7.1% cardiac failure, 14.3% stroke/TIA and 3.6% nephropathy. CONCLUSION: Target organ damage in the form of retinopathy, cardiac failure, TIA/stroke, nephropathy were found more in patients with increased left ventricular mass index than in patients with normal left ventricular mass index. Hence increased left ventricular mass index in essential hypertension is an important predictor of target organ damage which results in significant morbidity and mortality.