Prevalencia de hipertrofia ventricular izquierda, fibrilación auricular y enfermedad cardiovascular en hipertensos de Andalucía. Estudio PREHVIA

Abstract

Objectives The objective of the PREHVIA study was to assess the prevalence of electrocardiographic left ventricular hypertrophy (ECG-LVH) and of atrial fibrillation (AF) among Andalusian hypertensive patients, and the relationship of this complications with cardiovascular disease (CVD). Patients and methods Cross-sectional study with selection of study centres following the distribution of the Andalusian population by provinces and habitat, and randomization of patients included in the sample. Personal history was recorded, and ECG-LVH was assessed using the Cornell (voltage and product) and Sokolow-Lyon criteria, applied by the participant physicians and by an expert cardiologist. The association with ECG-HVH or CVD was studied by logistic regression models. Results In 570 patients (mean age 65 years, 54.5% women, 50.6% with obesity, 28,2% with diabetes), the prevalence of ECG-LVH was 13.7% (95% confidence interval [CI], 10.8–16.6%). Cornell criterion was fulfilled by 12.6% and Sokolow-Lyon by 1.6%. The prevalence of AF was 5.1% (95% CI, 3.9–7.5%) and 22.1% (95% CI, 18.4–25.4%) had established CVD. In the multivariate analysis, ECG-LVH was associated with female gender (odds ratio=5.10; 95% CI, 2.44–10.64) and with the presence of CVD (odds ratio=2.18; 95% CI, 1.09–4.12). The antecedent of CVD was independently associated with an advanced age, male gender, AF and, less strongly, with low glomerular filtration rate and diabetes mellitus. Conclusions In Andalusian hypertensives, the prevalence of ECG-LVH was significantly lower than that found in other studies, greater in women and at the expense of the Cornell criterion, the prevalence of AF was 5.1% and it was 22.1% for CVD with independent associations between ECG-LVH and between CVD and AF.