Gender differences in systolic left ventricular function in hypertensive patients with electrocardiographic left ventricular hypertrophy (the LIFE study)

Echocardiography was performed in 944 untreated hypertensive patients (391 women and 553 men, mean age 66 years) who had electrocardiographic left ven tricular (LV) hypertrophy at baseline in the Losartan Intervention For End point reduction in hypertension (LIFE) study to evaluate gender-associated differences in systolic LV function. Women had significantly lower diastoli c blood pressure (175/97 vs 173/99 mm Hg) and body surface area and a highe r body mass index (all p <0.01). Women also had higher LV election fraction (EF), endocardial and midwall fractional shortening (63% vs 60%, 35% and 3 3%, and 16% vs 15%, respectively, all p <0.01), higher stress-corrected mid wall fractional shortening (98% vs 96%, p <0.05), and lower circumferential end-systolic wall stress (178 vs 187 kdynes/cm(2), p <0.01). There was no difference in age or LV moss indexed for height(2.7), but relative wall thi ckness was higher in women (0.42 vs 0.41, p <0.05). In multiple regression analyses: (1) EF and endocardial fractionol shortening were 2% to 3% higher in women than men, independent of the effects of LV stress, body mass inde x, and height (multiple r = 0.77 and 0.75, respectively, gender p <0.02 in both models); (2) midwall fractional shortening was 0.5% higher in women, i ndependent of the effects of age, body moss index, circumferential end-syst olic stress, and absence of diabetes (multiple r = 0.36, p = 0.014 for gend er); and (3) stress-corrected LV midwall fractional shortening was 2% highe r (p = 0.004) in women, independent of the effects of age, height heart rat e, body mass index, and diabetes (multiple r = 0.33). Thus, female gender i s an independent predictor of higher systolic LV function in hypertensive p atients with electrocardiogrophic LV hypertrophy. (C) 2001 by Excerpta Medi co, Inc.