TY - JOUR
T1 - Regression of ECG-LVH is associated with lower risk of new-onset heart failure and mortality in patients with isolated systolic hypertension; The life study
AU - Larstorp, Anne Cecilie K.
AU - Okin, Peter M.
AU - Devereux, Richard B.
AU - Olsen, Michael H.
AU - Ibsen, Hans
AU - Dahlöf, Björn
AU - Kjeldsen, Sverre E.
AU - Wachtell, Kristian
PY - 2012/10/1
Y1 - 2012/10/1
N2 - Background Hypertension and electrocardiographic left ventricular hypertrophy (ECG-LVH) are strong predictors of heart failure (HF). It is unclear whether regression of ECG-LVH during treatment predicts less new-onset HF in patients with isolated systolic hypertension (ISH).MethodsA total of 9,027 patients with hypertension and ECG-LVH and without a history of HF were randomized to losartan-or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension study. Incident HF and the combined endpoint of HF and death were evaluated in 1,280 ISH patients and as compared with 7,747 patients with systolic-diastolic hypertension or isolated diastolic hypertension (non-ISH) during mean 4.8 0.9 years follow-up.ResultsNew-onset HF and HF or death occurred in 57 (4.5%) and 179 (14.0%) ISH patients and 220 (2.8%) and 787 (10.2%) non-ISH patients. In Cox regression analyses adjusting for treatment and HF risk factors, time-varying Cornell product was associated with lower risk of new-onset HF in ISH (adjusted hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.67-0.94, P = 0.008, per 1,050 mm × ms (1 SD) lower Cornell product) and in non-ISH (adjusted HR 0.67, 95% CI 0.61-0.72, P 0.001, per SD lower Cornell product). In parallel analyses, time-varying Cornell product was associated with lower risk of new-onset HF or death in ISH and non-ISH (adjusted HR 0.83, 95% CI 0.75-0.93, P = 0.001 and 0.82, 95% CI 0.77-0.87, P 0.001, per SD lower Cornell product).ConclusionsRegression of time-varying Cornell product was associated with similar reductions in risk of new-onset HF and the combined endpoint of HF or death in ISH and non-ISH patients.
AB - Background Hypertension and electrocardiographic left ventricular hypertrophy (ECG-LVH) are strong predictors of heart failure (HF). It is unclear whether regression of ECG-LVH during treatment predicts less new-onset HF in patients with isolated systolic hypertension (ISH).MethodsA total of 9,027 patients with hypertension and ECG-LVH and without a history of HF were randomized to losartan-or atenolol-based treatment in the Losartan Intervention For Endpoint reduction in hypertension study. Incident HF and the combined endpoint of HF and death were evaluated in 1,280 ISH patients and as compared with 7,747 patients with systolic-diastolic hypertension or isolated diastolic hypertension (non-ISH) during mean 4.8 0.9 years follow-up.ResultsNew-onset HF and HF or death occurred in 57 (4.5%) and 179 (14.0%) ISH patients and 220 (2.8%) and 787 (10.2%) non-ISH patients. In Cox regression analyses adjusting for treatment and HF risk factors, time-varying Cornell product was associated with lower risk of new-onset HF in ISH (adjusted hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.67-0.94, P = 0.008, per 1,050 mm × ms (1 SD) lower Cornell product) and in non-ISH (adjusted HR 0.67, 95% CI 0.61-0.72, P 0.001, per SD lower Cornell product). In parallel analyses, time-varying Cornell product was associated with lower risk of new-onset HF or death in ISH and non-ISH (adjusted HR 0.83, 95% CI 0.75-0.93, P = 0.001 and 0.82, 95% CI 0.77-0.87, P 0.001, per SD lower Cornell product).ConclusionsRegression of time-varying Cornell product was associated with similar reductions in risk of new-onset HF and the combined endpoint of HF or death in ISH and non-ISH patients.
KW - blood pressure
KW - Cornell product
KW - heart failure
KW - hypertension
KW - left ventricular hypertrophy
KW - Sokolow-Lyon voltage
UR - http://www.scopus.com/inward/record.url?scp=84866423739&partnerID=8YFLogxK
U2 - 10.1038/ajh.2012.86
DO - 10.1038/ajh.2012.86
M3 - Review
C2 - 22717544
AN - SCOPUS:84866423739
SN - 0895-7061
VL - 25
SP - 1101
EP - 1109
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 10
ER -