Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later

Background-Left ventricular hypertrophy (LVH) is a common risk factor for c ardiovascular mortality. Causes other than hypertension have not previously been investigated longitudinally. The aim of the present study was to dete rmine hemodynamic, metabolic, and psychosocial predictors at 50 years of ag e for the prevalence of echocardiographic LVH and geometric subtypes at age 70 by use of a large sample of men from the general population followed up fur 20 years. Methods and Results-In 1970 to 1973, all men born from 1920 to 1924 and res iding in Uppsala County, Sweden, were invited to participate in a health su rvey aimed at identifying risk factors for cardiovascular disease. At a rei nvestigation 20. years later, echocardiographic left ventricular mass index was determined in 475 subjects. A 1-SD increase in body mass index, systol ic or diastolic blood pressure, fasting LDL/HDL cholesterol, serum triglyce rides, or the serum cholesterol ester proportion of several saturated fatty acids or oleic acid at age 50 significantly increased the odds of having L VH at age 70 by 27% to 41%, whereas an increase in linoleic acid proportion was protective. Almost all metabolic predictors were independent of ischem ic heart disease, valvular disease, and use of antihypertensive medication at age 70. Conclusions-Dyslipidemia and indic es of a low dietary intake of linoleic a c id and high intake of saturated and monounsaturated fats, as well as hype rtension and obesity, at age 50 predicted the prevalence of LVH 20 years la ter in this prospective longitudinal cohort study, thereby suggesting that lipids may be important in the origin of LVH.