Prevalence of left ventricular hypertrophy and carotid thickening in a large selected hypertensive population: Impact of different echocardiographic and ultrasonographic diagnostic criteria

Background: Left ventricular hypertrophy (LVH) and increased carotid intima -media thickness (IMT) represent independent risk factors for cardiovascula r disease. Objective: To evaluate the prevalence of echocardiographic LVH a nd common carotid artery (CCA) intima-media (IM) thickening by different cr iteria in a large sample of hypertensive patients referred to our Hypertens ion Clinic. Methods: Echocardiograms and ultrasonographic carotid examinati ons have been performed in 640 consecutive hypertensives referred to our ou tpatient's hypertension unit. LVH was diagnosed using six different criteri a, when left ventricular mass index (LVMI) exceeded (a) 100 g/m(2) in women and 120 g/m(2) in men, 2 - 2 2 - 2 2 (b) 110 g/m(2) in women and 125 g/m(2 ) in men, (c) 110 g/m(2) in women and 134 g/m(2) in men, (d) 125 g/m(2) in both sexes, (e) 47 g/h(2.7) in women and 51 g/h(2.7) in men, (f) 105 g/h in women and 126 g/h in men. Thickening of CCA IM was identified using three partition values; when IMT was (a) greater than or equal to0.8 mm; (b) grea ter than or equal to0.9 mm; (c) greater than or equal to1.0 min in both sex es. Results: Echocardiographic and ultrasonographic examinations of suffici ent quality to be analysed were obtained in 611 patients (95.2%). Prevalenc e of LVH ranged from 18.6% (d) to 42.2% (f) and was significantly higher in men than in women by criteria (d) and (e), but slightly higher in women wh en using criteria (a) and (c). Eccentric hypertrophy was the most frequent type of LVH independently of the criteria used. Prevalence of IM thickening ranged from 14.7% (c) to 44.2% (a). Significant correlations between left ventricular mass (LVM)/body surface area, LVM/height and LVM/height(2.7), a nd carotid IM thickness were found (r = 0.41; p < 0.0001; r = 0.31, p < 0.0 001, r = 0.30; p < 0.0001, respectively). Conclusion: The prevalence of LVH and CCA IM thickening in hypertensive patients is markedly dependent on th e partition values used to define these markers of target organ damage. Con sidering the pivotal role of LVH and CCA IM thickening in assessing the glo bal cardiovascular risk profile in hypertensives, improved standardization in defining LVH and carotid IM thickening is needed.