Abstract 9592: Left Ventricular Hypertrophy Reduction and Clinical Events. A Meta-regression Analysis of 14 Studies in 12,809 Hypertensive Patients

Abstract

Objective: Left ventricular hypertrophy (LVH) is an independent risk factor for clinical events (CE), and disappearance of LVH is associated with reduction of cardiovascular risk. However, whether a continuous relationship between reduction of LVH and risk of CE exists has not been investigated. Methods: Randomized clinical trials evaluating LVH at baseline and reporting quantitative LVH changes and CE (all-cause death, myocardial infarction (MI), stroke or new onset heart failure) were included. Meta-regression analysis was performed to test the relationship between changes in LVH and incidence of the composite outcome (all-cause death, MI, stroke or new onset heart failure) and between changes of LVH and occurrence of each component of the composite outcome. Analysis of potential confounder variables was also performed. Results: Fourteen trials including 12,809 participants and reporting 2,259 events were included. Follow-up ranged from 0.50 to 5 years, with mean 1.97±1.50 years. Mean age was 62±5 years and 52% of patients were women. The composite outcome was significantly reduced by active treatments (odds ratio [OR]: 0.851, 95% confidence intervals [CI]: 0.780 to 0.929, p<0.001), as well stroke (OR: 0.756, CI:0.638 to 0.895, p<0.001) whereas MI (OR:1.031, CI:0.846 to 1.255, p=0.763) and new onset heart failure (OR:0.994, CI:0.798 to 1.238, p=0.955) were not significantly reduced by treatments. LVH changes did not predict the reduction of the risk of the composite outcome (t=0.69, p=0.50)(Figure) or all-cause death (t=-1.27, p=0.26), stroke (t=0.15, p=0.89), MI (t=1.20, p=0.28) and new onset heart failure (t=0.69, p=0.50). No significant influence on the association of baseline patients and studies characteristics was found. Conclusions: A significant continuous relationship between LVH changes and CE could not be demonstrated in hypertensive patients, independently on the technique or drug used. patients.