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Cited by 2,366Cardiovascular Function and Risk FactorsBlood Pressure and Hypertension StudiesCardiovascular Health and Disease Prevention

Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension

Koren, Michael J., Devereux, Richard B., Casale, Paul N., Savage, Daniel D., Laragh, John H.·1991·Annals of Internal Medicine
DOI 10.7326/0003-4819-114-5-345
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Abstract

OBJECTIVE: To assess the prognostic significance of left ventricular mass and geometry in initially healthy persons with essential hypertension. DESIGN: An observational study of a prospectively identified cohort. SETTING: University medical center. PATIENTS: Two hundred and eighty patients with essential hypertension and no pre-existing cardiac disease were evaluated using echocardiography between 1976 and 1981. Two hundred and fifty-three subjects or their family members (90%) were contacted for a follow-up interview an average of 10.2 years after the initial echocardiogram was obtained; the survival status of 27 patients lost to follow-up was ascertained using National Death Index data. MEASUREMENTS AND MAIN RESULTS: Left ventricular mass exceeded 125 g/m2 in 69 of 253 patients (27%). Cardiovascular events occurred in a higher proportion of patients with than without left ventricular hypertrophy (26% compared with 12%; P = 0.006). Patients with increased ventricular mass were also at higher risk for cardiovascular death (14% compared with 0.5%; P less than 0.001) and all-cause mortality (16% compared with 2%; P = 0.001). Electrocardiographic left ventricular hypertrophy did not predict risk. Patients with normal left ventricular geometry had the fewest adverse outcomes (no cardiac deaths; morbid events in 11%), and those with concentric hypertrophy had the most (death in 21%; morbid events in 31%). In a multivariate analysis, only age and left ventricular mass--but not gender, blood pressure, or serum cholesterol level--independently predicted all three outcome measures. CONCLUSIONS: Echocardiographically determined left ventricular mass and geometry stratify risk in patients with essential hypertension independently of and more strongly than blood pressure or other potentially reversible risk factors and may help to stratify the need for intensive treatment.

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  • In patients with hypertension, the occurrence of LVH has been associated with an increase in mortality from all cardiovascular causes.

    “In patients with hypertension, the occurrence of left ventricular hypertrophy (LVH) has been associated with an increase in mortality from all cardiovascular causes (1–4).”

    From Hypertensive left ventricular hypertrophy: relation to peripheral sympathetic drive (2001) · cites this paper as [2]

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Authors
Koren, M. J., Devereux, R. B., Casale, P. N., Savage, D. D., & Laragh, J. H.
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1991-03-01
Volume
114
Issue
5
Pages
345-352
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-114-5-345
OpenAlex
W1992890029
Cited by
2,366
References
49
Citations by year
2026: 16 · 2025: 17 · 2024: 28 · 2023: 40 · 2022: 44 · 2021: 44 · 2020: 39 · 2019: 46 · 2018: 50 · 2017: 56 · 2016: 74 · 2015: 74 · 2014: 71 · 2013: 74 · 2012: 94
FWCI
53.66
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (2p50hl018323-17)
  • National Heart, Lung, and Blood Institute (HL18323)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
left ventricular mass, left ventricular geometry, essential hypertension, left ventricular hypertrophy, concentric hypertrophy, cardiovascular mortality, cardiovascular morbidity, prognosis, risk stratification, echocardiography, electrocardiographic left ventricular hypertrophy
MeSH terms
Adult, Cardiovascular Diseases, Echocardiography, Female, Cardiomegaly, Humans, Hypertension, Male, Middle Aged, Prospective Studies, Risk Factors, Statistics as Topic

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