Prevalence and covariates of electrocardiographic left ventricular hypertrophy in the Hypertension in the Very Elderly Trial.

OBJECTIVE

To estimate the prevalence and covariates of electrocardiographic left ventricular hypertrophy (LVH) in the Hypertension in the Very Elderly Trial.

METHODS

A total of 2993 hypertensive people aged at least 80 years with technically codable ECGs without pacing, bundle branch block, or ECG myocardial infarction were studied. LVH was assessed using Sokolow-Lyon (SL-LVH), Cornell voltage (CV-LVH), and Cornell product criterion (CP-LVH).

RESULTS

The prevalence of LVH varied from 2.4 to 17.5% depending on sex, race, and ECG criterion. The highest prevalence of SL-LVH (12.0%) was in Chinese men and in white women for both CV-LVH (17.5%) and CP-LVH (12.9%). Increasing SBP was an independent covariate of the presence of LVH in Chinese women independently of the criterion used (β = 0.052-0.069, P < 0.001), of SL-LVH in Chinese men (β = 0.047 P = 0.006). In white women, CP-LVH was associated with increasing age (β = 0.055, P = 0.027) and SBP (β = 0.023, P = 0.040). Increasing BMI was associated inversely with SL-LVH; the association in white men only was not significant. In white men, a history of diabetes was directly and history of antihypertensive drug treatment inversely related to CV-LVH and CP-LVH. SL-ECG was associated inversely to serum uric acid concentration in Chinese women and to serum hemoglobin concentration in Chinese men.

CONCLUSION

Prevalence and covariates of electrocardiographic LVH varied by sex, race, and ECG criterion. CP-LVH may prove to be the most useful measure of LVH in this study owing to its close relationship to SBP, at least in women, and independence from BMI.