Left ventricular hypertrophy as a surrogate end-point in hypertension

Objectives: To examine the adequacy of available evidence that left ventric ular hypertrophy (LVH) and its regression influence the rate of cardiovascu lar events in hypertension Design and Methods: Statistical, epidemiologic and treatment trial literatu re concerning ECG and echocardiographic LVH was reviewed to address the abo ve question. Results: Results of 7 electrocardiographic and 10 echocardiographic studies (total n about 20,000 subjects) show consistently higher risks of morbid e vents in individuals with than without LVH (odds ratios 1.4 to 5.4). Availa ble data (5 studies, 1,544 subjects) suggest that morbid events occur in hi gher proportions of individuals in whom LVH progresses (13 to 59%) than reg resses (7 to 12%). Conclusions: Strict criteria to establish LVH as a fully adequate surrogate end-point for morbid events in hypertension are being increasingly satisfi ed by mounting evidence, but the independence of the relation of LVH change to prognosis from blood pressure or other factors has not yet been fully e stablished.