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August 1, 1993The American Journal of Cardiology298 citationsOpen Access

Sex differences in cardiac adaptation to isolated systolic hypertension

HKHarlan M. KrumholzMLMartin G. LarsonDLDaniel Levy

Key Result

Isolated systolic hypertension increased the odds of left ventricular hypertrophy in men (OR 2.58; 95% CI 0.97-6.86) and women (OR 5.94; 95% CI 3.06-11.53), with differing geometric patterns.

Study Design

Type

Cross-Sectional (n=1,361)

Structured PICO

Does isolated systolic hypertension differentially affect left ventricular mass and geometry in men versus women?

P
Population
1,361 adults aged ≥50 years, free of clinical cardiovascular disease and not on antihypertensive medication, assessed for left ventricular hypertrophy.
E
Exposure
Isolated systolic hypertension
C
Comparator
Normotension
O
Outcome
Left ventricular mass and geometry (including LV hypertrophy, wall thickness, and chamber enlargement) assessed by M-mode echocardiographysurrogate

Isolated systolic hypertension is associated with increased left ventricular mass in both sexes, but leads to a concentric hypertrophy pattern in women and an eccentric pattern in men.

Main Result

Effect estimate: OR 2.58 in men, OR 5.94 in women (95% CI 0.97-6.86 in men, 3.06-11.53 in women)

Abstract

This study examines the association of isolated systolic hypertension with left ventricular (LV) mass and geometry in men and women. The subjects of this study were surviving members of the Framingham Heart Study and the Framingham Offspring Study who attended the index examination (between 1979 and 1983) and were aged > or = 50 years, free of clinically apparent cardiovascular disease, not taking antihypertensive medication and without diastolic hypertension (diastolic blood pressure < 90 mm Hg), and in whom LV mass could be determined by echocardiography. Examinations routinely included 12-lead resting electrocardiography, measurements of resting blood pressure, anthropometry, blood glucose levels, and M-mode echocardiography. M-mode echocardiograms adequate to assess LV hypertrophy were obtained for 1,282 normotensive subjects (538 men and 744 women) and 79 subjects with isolated systolic hypertension (26 men and 53 women). Adjusting for age, body mass index and diastolic blood pressure, the relative odds of LV hypertrophy associated with isolated systolic hypertension were 2.58 (95% confidence interval 0.97 to 6.86) in men and 5.94 (95% confidence interval 3.06 to 11.53) in women. Women with isolated systolic hypertension had increased LV wall thickness and mass without LV chamber enlargement, but men had LV dilation and increased LV mass without increased wall thickness. In conclusion, although isolated systolic hypertension was associated with increased LV mass in men and women, the geometric pattern of increased LV mass differed by sex; although women demonstrated a pattern of concentric hypertrophy, an eccentric pattern was observed in men.

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Cite This Study

Krumholz et al. (1993) conducted a cross-sectional in Isolated systolic hypertension (n=1,361). Isolated systolic hypertension vs. Normotension was evaluated on Left ventricular hypertrophy (OR 2.58 in men, OR 5.94 in women, 95% CI 0.97-6.86 in men, 3.06-11.53 in women). Isolated systolic hypertension increased the odds of left ventricular hypertrophy in men (OR 2.58; 95% CI 0.97-6.86) and women (OR 5.94; 95% CI 3.06-11.53), with differing geometric patterns.

synapsesocial.com/papers/6aa3778535cd30b462c60e56https://doi.org/10.1016/0002-9149(93)90678-6
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