TY - JOUR
T1 - Predictive Performance of Echocardiographic Parameters for Cardiovascular Events Among Elderly Treated Hypertensive Patients
AU - Chowdhury, E. K.
AU - Jennings, Garry
AU - Dewar, Elizabeth
AU - Wing, Lindon
AU - Reid, Christopher
PY - 2016
Y1 - 2016
N2 - BACKGROUND Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderly hypertensive patients without heart failure. METHODS Data from LVH substudy of the Second Australian National Blood Pressure trial were used. Echocardiograms were performed at entry into the study. Cardiovascular outcomes were identified over short term (median 4.2 years) and long term (median 10.9 years). LVH was defined using threshold values of LV mass (LVM) indexed to either body surface area (BSA) or height2.7: >115/95 g/m2 (LVH-BSA115/95) or ?49/45 g/m2.7 (LVH-ht49/45) in males/females, respectively, and ?125 g/m2 (LVH-BSA125) or ?51 g/m2.7 (LVH-ht51) for both sexes. RESULTS In the 666 participants aged ?65 years in this analysis, LVH prevalence at baseline was 33%-70% depending on definition; and after adjusting for potential risk factors, only LVH-BSA115/95 predicted both short-and long-term cardiovascular outcomes. Participants having LVH-BSA115/95 (69%) at baseline had twice the risk of having any first cardiovascular event over the short term (hazard ratio, 95% confidence interval: 2.00, 1.12-3.57, P = 0.02) and any fatal cardiovascular events (2.11, 1.21-3.68, P = 0.01) over the longer term. Among other echocardiographic parameters, LVM and LVM indexed to either BSA or height2.7 predicted cardiovascular events over both short and longer term. CONCLUSIONS In elderly treated hypertensive patients without heart failure, determining LVH by echocardiography is highly dependent on the methodology adopted. LVH-BSA115/95 is a reliable predictor of future cardiovascular outcomes in the elderly.
AB - BACKGROUND Hypertension leads to cardiac structural and functional changes, commonly assessed by echocardiography. In this study, we assessed the predictive performance of different echocardiographic parameters including left ventricular hypertrophy (LVH) on future cardiovascular outcomes in elderly hypertensive patients without heart failure. METHODS Data from LVH substudy of the Second Australian National Blood Pressure trial were used. Echocardiograms were performed at entry into the study. Cardiovascular outcomes were identified over short term (median 4.2 years) and long term (median 10.9 years). LVH was defined using threshold values of LV mass (LVM) indexed to either body surface area (BSA) or height2.7: >115/95 g/m2 (LVH-BSA115/95) or ?49/45 g/m2.7 (LVH-ht49/45) in males/females, respectively, and ?125 g/m2 (LVH-BSA125) or ?51 g/m2.7 (LVH-ht51) for both sexes. RESULTS In the 666 participants aged ?65 years in this analysis, LVH prevalence at baseline was 33%-70% depending on definition; and after adjusting for potential risk factors, only LVH-BSA115/95 predicted both short-and long-term cardiovascular outcomes. Participants having LVH-BSA115/95 (69%) at baseline had twice the risk of having any first cardiovascular event over the short term (hazard ratio, 95% confidence interval: 2.00, 1.12-3.57, P = 0.02) and any fatal cardiovascular events (2.11, 1.21-3.68, P = 0.01) over the longer term. Among other echocardiographic parameters, LVM and LVM indexed to either BSA or height2.7 predicted cardiovascular events over both short and longer term. CONCLUSIONS In elderly treated hypertensive patients without heart failure, determining LVH by echocardiography is highly dependent on the methodology adopted. LVH-BSA115/95 is a reliable predictor of future cardiovascular outcomes in the elderly.
UR - http://ajh.oxfordjournals.org/content/early/2016/04/23/ajh.hpw035.abstract
U2 - 10.1093/ajh/hpw035
DO - 10.1093/ajh/hpw035
M3 - Article
VL - 29
SP - 821
EP - 831
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 7
ER -