CLINICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY AS A POTENTIAL INDICATOR OF MASKED HYPERTENSION AMONG THE KOREAN ELDERLY

Abstract

Objective: Although masked hypertension links to adverse cardiovascular outcomes, it is challenging to distinguish individuals with masked hypertension. Studies have demonstrated a significant association between left ventricular hypertrophy (LVH) and masked hypertension. However, it remains unclear whether electrocardiographic LVH has the predictability for masked hypertension. Design and method: The study participants were 511 Korean elderly with well-controlled blood pressure (BP) or normotension who underwent electrocardiography and ambulatory blood pressure monitoring (ABPM). We categorized them into two groups by presence or absence of electrocardiographic LVH. We conducted Pearson correlation analysis (beta coefficient [95% confidence interval] and logistic regression analysis (odd ratio (OR) [95% CI]) to evaluate the association of electrocardiographic LVH with components of ABPM. The area under the receiver operator curve (AUC) was calculated to assess the predictability of electrocardiographic LVH for 24-hour average masked hypertension. Results: Electrocardiographic LVH significantly correlated with 24-hour mean systolic blood pressure (SBP) (5.83 [2.16-9.51]), daytime SBP (5.0 [1.27-8.72]), and nighttime SBP (7.89 [3.49-12.30]). Electrocardiographic LVH showed the increased OR for masked hypertension in 24-hour average BP (2.18 [1.17-4.07]), in daytime average BP (2.03 [1.09-3.79]), and nighttime average BP (1.83 [0.86-3.88]). The receiver operating curve indicated the significant predictability of electrocardiographic LVH for 24-hour average masked hypertension (area under the curve: 0.706 [0.604-0.809]). Conclusions: Electrocardiographic LVH is potentially effective in distinguishing individuals with masked hypertension.