Abstract
BackgroundElectrocardiographic left ventricular hypertrophy (ECG-LVH) is a common manifestation of preclinical cardiovascular disease. The present study aimed to investigate risk factors for ECG-LVH and its prevalence in a cohort of young Chinese individuals.Methods(1) A total of 1515 participants aged 36–45 years old from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine risk factors for ECG-LVH and its prevalence. (2) A total of 235 participants were recruited from the same cohort in 2013 and were followed up in 2017. Longitudinal analysis was used to determine the predictors of LVH occurrence over the 4-year period. We used multivariable logistic regression models to calculate OR and 95% CIs and to analyze risk factors for ECG-LVH.ResultsIn the cross-sectional analysis, the prevalence of LVH diagnosed by the Cornell voltage-duration product in the overall population and the hypertensive population was 4.6% and 8.8%, respectively. The logistic regression results shown that female sex [2.611 (1.591–4.583)], hypertension [2.638 (1.449–4.803)], systolic blood pressure (SBP) [1.021 (1.007–1.035)], serum uric acid (SUA) [1.004 (1.001–1.006)] and carotid intima-media thickness (CIMT) [67.670 (13.352–342.976)] were significantly associated with the risk of LVH (all P < 0.05). In the longitudinal analysis, fasting glucose [1.377 (1.087–1.754)], SBP [1.046 (1.013–1.080)] and female sex [1.242 (1.069–1.853)] were independent predictors for the occurrence of LVH in the fourth year of follow-up.ConclusionsOur study suggested that female sex, hypertension, SBP, SUA and CIMT were significantly associated with the risk of LVH in young people. In addition, fasting glucose, SBP and female sex are independent predictors of the occurrence of LVH in a young Chinese general population.
Highlights
Electrocardiographic left ventricular hypertrophy (ECG-Left ventricular hypertrophy (LVH)) is a common manifestation of preclinical cardiovascular disease
Our study suggested that female sex, hypertension, systolic blood pressure (SBP), serum uric acid (SUA) and carotid intima-media thickness (CIMT) were significantly associated with the risk of LVH in young people
No of subjects Age, y Female, no. (%) body mass index (BMI), Kg/m2 waisthip ratio (WHR) Current smoking, no. (%) alcohol use, no. (%) Hypertension, no. (%) Diabetes mellitus, no. (%) SBP, mmHg diastolic blood pressure (DBP), mmHg Heart rate, beats/min SUA, μmol/L Serum creatinine, umol/L estimated glomerular filtration rate (eGFR), mL/min/1.73m2 Fasting glucose, mmol/L Total cholesterol, mmol/L Triglycerides, mmol/L Low-density lipoprotein cholesterol (LDL-C), mmol/L high-density lipoprotein cholesterol (HDL-C), mmol/L urinary uric acid/creatinine ratio (uUA/Cre) UACR, mg/g High-sensi‐ tivity C-reactive protein (hs-CRP), mg/L CIMT, mm Cornell index, mm ms Normally distributed variables are expressed as mean ± SD as determined by the Student’s t-test, non-normally distributed variables are expressed as medians as determined by Mann–Whitney test, categorical variables are expressed as numbers and percentages by χ2-test
Summary
Electrocardiographic left ventricular hypertrophy (ECG-LVH) is a common manifestation of preclinical cardiovascular disease. LVH can be present in normotensive subjects, and the severity of hypertension is far from explaining the changes in left ventricular mass index (LVMI) [6] Nonhemodynamic mechanisms, such as metabolic factors and genetic factors, are likely to contribute to the development of LVH. Nonhaemodynamic factors are likely to be involved in the pathogenesis of LVH, as increased blood pressure values explain less than 30% of variations in LVMI, both in normotensive and hypertensive subjects [7] Some risk factors, such as age, sex [8], body mass index (BMI) [9], SUA [10], insulin resistance and diabetes mellitus [11, 12], may all play roles in the pathogenesis of LVH. It is of great significance to identify the prevalence and related risk factors of LVH in young subjects
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