Left ventricular mass and cardiovascular morbidity in essential hypertension: The MAVI study

OBjectives This study investigated the prognostic value of left ventricular (LV) mass at echo cardiography in uncomplicated subjects with essential hy pertension. Background Only a few single-center studies support the prognostic value of LV mass in uncomplicated hypertension. Methods The MAssa Ventricolare sinistra nell'Ipertensione study was a multi center (45 centers) prospective study. The prespecified aim was to explore the prognostic value of LV mass in hypertension Admission criteria included essential hypertension, no previous cardiovascular events, and age greater than or equal to 50. There was central reading of echo cardiographic traci ngs. Treatment was tailored to the single subject. Results Overall, 1,033 subjects (396 men) were followed for 0 to 4 years (m edian, 3 years). Mean age at entry was 60 years, and systolic/diastolic blo od pressure was 154/92 mm Hg. The rate of cardiovascular events (x 100 pati ent-years) was 1.3 in the group with normal LV mass and 3.2 in the group (2 8.5% of total sample) with LV mass greater than or equal to 125 g/body surf ace area (p=0.005). After adjustment for age (p<0.01), diabetes (p<0.01), c igarette smoking (p<0.01) and serum creatinine (p=0.03), LV hypertrophy was associated with an increased risk of events (RR [relative risk] 2.09; 95% CI [confidence interval]: 1.22 to 3.57). For each 39 g/m(2) (I SD) increase in LV mass there was an independent 40% rise in the risk of major cardiova scular events (95% CI: 14 to 72; p=0.0013). Conclusions Our findings show a strong, continuous and independent relation ship of LV mass to subsequent cardiovascular morbidity. This is the first s tudy to extend such demonstration to a large nationwide multicenter sample of uncomplicated subjects with essential hypertension. (J Am Coli Cardiol 2 001;38:1829-35) (C) 2001 by the American College of Cardiology.