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CP-LVH predicts stroke in general populace
18 November 2008
MedWire News: Left ventricular hypertrophy (LVH), especially when defined using Cornell product (CP) criteria, predicts stroke in the Japanese population, say researchers.
Joki Ishikawa (Jichi Medical University, Shimotsuke, Japan) and colleagues used the CP and Sokolow-Lyon (SL) criteria to determine LVH in 10,755 Japanese individuals.
“CP-LVH and SL-LVH were related to different risk factors, although they were both electrocardiogram markers of LVH,” the team writes in the journal Hypertension.
Overall, CP-LVH, but not SL-LVH, tended to be related to metabolic factors. For example, in normotensive participants, CP-LVH but not SL-LVH was related to the presence of hyperlipidemia and diabetes, whereas, in hypertensive people, only SL-LVH was associated with the absence of diabetes or impaired fasting glucose.
CP-LVH occurred in 2.7%, 5.2%, and 11.0% of normotensive, prehypertensive, and hypertensive people, respectively, while SL-LVH was present in 5.0%, 8.2%, and 15.2%.
LVH predicted stroke, which occurred in 391 people during 10 years of follow-up, but not myocardial infarction. Overall, the presence of CP-LVH raised stroke risk 1.62 fold and SL-LVH increased it 1.29 fold, but the latter association lost significance after accounting for confounders.
The predictive value of CP-LVH for stroke was similar in prehypertensive and hypertensive people, but was particularly strong in those with normal blood pressure, in whom it was associated with a 7.53-fold increase in stroke risk.
Adding CP-LVH to a model of traditional risk factors, including age, history of stroke, smoking, hyperlipidemia, diabetes and systolic blood pressure, improved its ability to predict stroke. But adding SL-LVH to the model had no effect.
The team notes that CP-LVH is thought to reflect relative wall thickness better than does SL-LVH, and that relative wall thickness is greater in diabetic than nondiabetic people.
“The higher predictive value of stroke might be derived from that of diabetes-associated relative wall thickness,” suggest Ishikawa et al.
They conclude: “Evaluation of CP-LVH may be useful for detecting normotensive diabetic subjects at greatest risk for stroke.”
