Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Hypertension | Research article

Risk factors for electrocardiographic left ventricular hypertrophy in a young Chinese general population: the Hanzhong adolescent cohort study

Authors: Yue-Yuan Liao, Ke Gao, Bo-Wen Fu, Lei Yang, Wen-Jing Zhu, Qiong Ma, Chao Chu, Yu Yan, Yang Wang, Wen-Ling Zheng, Jia-Wen Hu, Ke-Ke Wang, Yue Sun, Chen Chen, Jian-Jun Mu

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Login to get access

Abstract

Background

Electrocardiographic left ventricular hypertrophy (ECG-LVH) is a common manifestation of preclinical cardiovascular disease. The present study aimed to investigate risk factors for ECG-LVH and its prevalence in a cohort of young Chinese individuals.

Methods

(1) A total of 1515 participants aged 36–45 years old from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine risk factors for ECG-LVH and its prevalence. (2) A total of 235 participants were recruited from the same cohort in 2013 and were followed up in 2017. Longitudinal analysis was used to determine the predictors of LVH occurrence over the 4-year period. We used multivariable logistic regression models to calculate OR and 95% CIs and to analyze risk factors for ECG-LVH.

Results

In the cross-sectional analysis, the prevalence of LVH diagnosed by the Cornell voltage-duration product in the overall population and the hypertensive population was 4.6% and 8.8%, respectively. The logistic regression results shown that female sex [2.611 (1.591–4.583)], hypertension [2.638 (1.449–4.803)], systolic blood pressure (SBP) [1.021 (1.007–1.035)], serum uric acid (SUA) [1.004 (1.001–1.006)] and carotid intima-media thickness (CIMT) [67.670 (13.352–342.976)] were significantly associated with the risk of LVH (all P < 0.05). In the longitudinal analysis, fasting glucose [1.377 (1.087–1.754)], SBP [1.046 (1.013–1.080)] and female sex [1.242 (1.069–1.853)] were independent predictors for the occurrence of LVH in the fourth year of follow-up.

Conclusions

Our study suggested that female sex, hypertension, SBP, SUA and CIMT were significantly associated with the risk of LVH in young people. In addition, fasting glucose, SBP and female sex are independent predictors of the occurrence of LVH in a young Chinese general population.
Appendix
Available only for authorised users
Literature
1.
go back to reference Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J. 2001;141(3):334–41.CrossRef Vakili BA, Okin PM, Devereux RB. Prognostic implications of left ventricular hypertrophy. Am Heart J. 2001;141(3):334–41.CrossRef
2.
go back to reference Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1991;114(5):345–52.CrossRef Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1991;114(5):345–52.CrossRef
3.
go back to reference Mancia G, Carugo S, Grassi G, Lanzarotti A, Schiavina R, Cesana G, et al. Prevalence of left ventricular hypertrophy in hypertensive patients without and with blood pressure control: data from the PAMELA population. PressioniArterioseMonitorate E LoroAssociazioni. Hypertension. 2002;39(3):744–9.CrossRef Mancia G, Carugo S, Grassi G, Lanzarotti A, Schiavina R, Cesana G, et al. Prevalence of left ventricular hypertrophy in hypertensive patients without and with blood pressure control: data from the PAMELA population. PressioniArterioseMonitorate E LoroAssociazioni. Hypertension. 2002;39(3):744–9.CrossRef
4.
go back to reference Dahlof B. Left ventricular hypertrophy and angiotensin II antagonists. Am J Hypertens. 2001;14(2):174–82.CrossRef Dahlof B. Left ventricular hypertrophy and angiotensin II antagonists. Am J Hypertens. 2001;14(2):174–82.CrossRef
5.
go back to reference Dunn FG, McLenachan J, Isles CG, Brown I, Dargie HJ, Lever AF, et al. Left ventricular hypertrophy and mortality in hypertension: an analysis of data from the Glasgow Blood Pressure Clinic. J Hypertens. 1990;8(8):775–82.CrossRef Dunn FG, McLenachan J, Isles CG, Brown I, Dargie HJ, Lever AF, et al. Left ventricular hypertrophy and mortality in hypertension: an analysis of data from the Glasgow Blood Pressure Clinic. J Hypertens. 1990;8(8):775–82.CrossRef
6.
go back to reference Rowlands DB, Glover DR, Ireland MA, McLeay RA, Stallard TJ, Watson RD, et al. Assessment of left-ventricular mass and its response to antihypertensive treatment. Lancet. 1982;1(8270):467–70.CrossRef Rowlands DB, Glover DR, Ireland MA, McLeay RA, Stallard TJ, Watson RD, et al. Assessment of left-ventricular mass and its response to antihypertensive treatment. Lancet. 1982;1(8270):467–70.CrossRef
7.
go back to reference Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102(4):470–9.CrossRef Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102(4):470–9.CrossRef
8.
go back to reference Gardin JM, Siscovick D, Anton-Culver H, Lynch JC, Smith VE, Klopfenstein HS, et al. Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. Cardiovas Health Study Circ. 1995;91(6):1739–48. Gardin JM, Siscovick D, Anton-Culver H, Lynch JC, Smith VE, Klopfenstein HS, et al. Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. Cardiovas Health Study Circ. 1995;91(6):1739–48.
9.
go back to reference Bombelli M, Facchetti R, Sega R, Carugo S, Fodri D, Brambilla G, et al. Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension. 2011;58(6):1029–35.CrossRef Bombelli M, Facchetti R, Sega R, Carugo S, Fodri D, Brambilla G, et al. Impact of body mass index and waist circumference on the long-term risk of diabetes mellitus, hypertension, and cardiac organ damage. Hypertension. 2011;58(6):1029–35.CrossRef
10.
go back to reference Viazzi F, Parodi D, Leoncini G, Parodi A, Falqui V, Ratto E, et al. Serum uric acid and target organ damage in primary hypertension. Hypertension. 2005;45(5):991–6.CrossRef Viazzi F, Parodi D, Leoncini G, Parodi A, Falqui V, Ratto E, et al. Serum uric acid and target organ damage in primary hypertension. Hypertension. 2005;45(5):991–6.CrossRef
11.
go back to reference Lind L, Andersson PE, Andren B, Hanni A, Lithell HO. Left ventricular hypertrophy in hypertension is associated with the insulin resistance metabolic syndrome. J Hypertens. 1995;13(4):433–8.CrossRef Lind L, Andersson PE, Andren B, Hanni A, Lithell HO. Left ventricular hypertrophy in hypertension is associated with the insulin resistance metabolic syndrome. J Hypertens. 1995;13(4):433–8.CrossRef
12.
go back to reference Li T, Chen S, Guo X, Yang J, Sun Y. Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study. BMC Cardiovasc Disord. 2017;17(1):206.CrossRef Li T, Chen S, Guo X, Yang J, Sun Y. Impact of hypertension with or without diabetes on left ventricular remodeling in rural Chinese population: a cross-sectional study. BMC Cardiovasc Disord. 2017;17(1):206.CrossRef
13.
go back to reference Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China: results From the China Hypertension Survey, 2012–2015. Circulation. 2018;137(22):2344–56.CrossRef Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China: results From the China Hypertension Survey, 2012–2015. Circulation. 2018;137(22):2344–56.CrossRef
14.
go back to reference Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation. 2008;118(25):2679–86.CrossRef Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation. 2008;118(25):2679–86.CrossRef
15.
go back to reference Wang Y, Hu JW, Qu PF, Wang KK, Yan Y, Chu C, et al. Association between urinary sodium excretion and uric acid, and its interaction on the risk of prehypertension among Chinese young adults. Sci Rep. 2018;8(1):7749.CrossRef Wang Y, Hu JW, Qu PF, Wang KK, Yan Y, Chu C, et al. Association between urinary sodium excretion and uric acid, and its interaction on the risk of prehypertension among Chinese young adults. Sci Rep. 2018;8(1):7749.CrossRef
16.
go back to reference Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, et al. Association of blood pressure trajectories in early life with subclinical renal damage in middle age. J Am SocNephrol. 2018;29(12):2835–46. Zheng W, Mu J, Chu C, Hu J, Yan Y, Ma Q, et al. Association of blood pressure trajectories in early life with subclinical renal damage in middle age. J Am SocNephrol. 2018;29(12):2835–46.
17.
go back to reference Wang Y, Yuan Y, Gao WH, Yan Y, Wang KK, Qu PF, et al. Predictors for progressions of brachial-ankle pulse wave velocity and carotid intima-media thickness over a 12-year follow-up: Hanzhong Adolescent Hypertension Study. J Hypertens. 2019;37(6):1167–75.CrossRef Wang Y, Yuan Y, Gao WH, Yan Y, Wang KK, Qu PF, et al. Predictors for progressions of brachial-ankle pulse wave velocity and carotid intima-media thickness over a 12-year follow-up: Hanzhong Adolescent Hypertension Study. J Hypertens. 2019;37(6):1167–75.CrossRef
18.
go back to reference Wang Y, Lv YB, Chu C, Wang M, Xie BQ, Wang L, et al. Plasma renalase is not associated with blood pressure and brachial-ankle pulse wave velocity in Chinese adults with normal renal function. Kidney Blood Press Res. 2016;41(6):837–47.CrossRef Wang Y, Lv YB, Chu C, Wang M, Xie BQ, Wang L, et al. Plasma renalase is not associated with blood pressure and brachial-ankle pulse wave velocity in Chinese adults with normal renal function. Kidney Blood Press Res. 2016;41(6):837–47.CrossRef
19.
go back to reference Wang Y, Chu C, Wang KK, Hu JW, Yan Y, Lv YB, et al. Effect of salt intake on plasma and urinary uric acid levels in chinese adults: an interventional trial. Sci Rep. 2018;8(1):1434.CrossRef Wang Y, Chu C, Wang KK, Hu JW, Yan Y, Lv YB, et al. Effect of salt intake on plasma and urinary uric acid levels in chinese adults: an interventional trial. Sci Rep. 2018;8(1):1434.CrossRef
20.
go back to reference Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006;17(10):2937–44.CrossRef Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, et al. Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol. 2006;17(10):2937–44.CrossRef
21.
go back to reference Okin PM, Devereux RB, Jern S, Julius S, Kjeldsen SE, Dahlof B. Relation of echocardiographic left ventricular mass and hypertrophy to persistent electrocardiographic left ventricular hypertrophy in hypertensive patients: the LIFE Study. Am J Hypertens. 2001;14(8 Pt 1):775–82.CrossRef Okin PM, Devereux RB, Jern S, Julius S, Kjeldsen SE, Dahlof B. Relation of echocardiographic left ventricular mass and hypertrophy to persistent electrocardiographic left ventricular hypertrophy in hypertensive patients: the LIFE Study. Am J Hypertens. 2001;14(8 Pt 1):775–82.CrossRef
22.
go back to reference Bruno G, Giunti S, Bargero G, Ferrero S, Pagano G, Perin PC. Sex-differences in prevalence of electrocardiographic left ventricular hypertrophy in Type 2 diabetes: the Casale Monferrato Study. Diabetic Med. 2004;21(8):823–8.CrossRef Bruno G, Giunti S, Bargero G, Ferrero S, Pagano G, Perin PC. Sex-differences in prevalence of electrocardiographic left ventricular hypertrophy in Type 2 diabetes: the Casale Monferrato Study. Diabetic Med. 2004;21(8):823–8.CrossRef
23.
go back to reference Ishikawa J, Ishikawa S, Kabutoya T, Gotoh T, Kayaba K, Schwartz JE, et al. Cornell product left ventricular hypertrophy in electrocardiogram and the risk of stroke in a general population. Hypertension. 2009;53(1):28–34.CrossRef Ishikawa J, Ishikawa S, Kabutoya T, Gotoh T, Kayaba K, Schwartz JE, et al. Cornell product left ventricular hypertrophy in electrocardiogram and the risk of stroke in a general population. Hypertension. 2009;53(1):28–34.CrossRef
24.
go back to reference Lehtonen AO, Puukka P, Varis J, Porthan K, Tikkanen JT, Nieminen MS, et al. Prevalence and prognosis of ECG abnormalities in normotensive and hypertensive individuals. J Hypertens. 2016;34(5):959–66.CrossRef Lehtonen AO, Puukka P, Varis J, Porthan K, Tikkanen JT, Nieminen MS, et al. Prevalence and prognosis of ECG abnormalities in normotensive and hypertensive individuals. J Hypertens. 2016;34(5):959–66.CrossRef
25.
go back to reference Lin TH, Chiu HC, Su HM, Voon WC, Liu HW, Lai WT, et al. Association between fasting plasma glucose and left ventricular mass and left ventricular hypertrophy over 4 years in a healthy population aged 60 and older. J Am Geriatr Soc. 2007;55(5):717–24.CrossRef Lin TH, Chiu HC, Su HM, Voon WC, Liu HW, Lai WT, et al. Association between fasting plasma glucose and left ventricular mass and left ventricular hypertrophy over 4 years in a healthy population aged 60 and older. J Am Geriatr Soc. 2007;55(5):717–24.CrossRef
26.
go back to reference Rutter MK, Parise H, Benjamin EJ, Levy D, Larson MG, Meigs JB, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation. 2003;107(3):448–54.CrossRef Rutter MK, Parise H, Benjamin EJ, Levy D, Larson MG, Meigs JB, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation. 2003;107(3):448–54.CrossRef
27.
go back to reference Ohya Y, Abe I, Fujii K, Ohmori S, Onaka U, Kobayashi K, et al. Hyperinsulinemia and left ventricular geometry in a work-site population in Japan. Hypertension. 1996;27(3 Pt 2):729–34.CrossRef Ohya Y, Abe I, Fujii K, Ohmori S, Onaka U, Kobayashi K, et al. Hyperinsulinemia and left ventricular geometry in a work-site population in Japan. Hypertension. 1996;27(3 Pt 2):729–34.CrossRef
28.
go back to reference Iwashima Y, Horio T, Kamide K, Rakugi H, Ogihara T, Kawano Y. Uric acid, left ventricular mass index, and risk of cardiovascular disease in essential hypertension. Hypertension. 2006;47(2):195–202.CrossRef Iwashima Y, Horio T, Kamide K, Rakugi H, Ogihara T, Kawano Y. Uric acid, left ventricular mass index, and risk of cardiovascular disease in essential hypertension. Hypertension. 2006;47(2):195–202.CrossRef
29.
go back to reference Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67(5):1739–42.CrossRef Khosla UM, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67(5):1739–42.CrossRef
30.
go back to reference Kim NH, Shin MH, Kweon SS, Ko JS, Lee YH. Carotid Atherosclerosis and electrocardiographic left ventricular hypertrophy in the general population: the Namwon study. Chonnam Med J. 2017;53(2):153–60.CrossRef Kim NH, Shin MH, Kweon SS, Ko JS, Lee YH. Carotid Atherosclerosis and electrocardiographic left ventricular hypertrophy in the general population: the Namwon study. Chonnam Med J. 2017;53(2):153–60.CrossRef
31.
go back to reference Vaudo G, Schillaci G, Evangelista F, Pasqualini L, Verdecchia P, Mannarino E. Arterial wall thickening at different sites and its association with left ventricular hypertrophy in newly diagnosed essential hypertension. Am J Hypertens. 2000;13(4 Pt 1):324–31.CrossRef Vaudo G, Schillaci G, Evangelista F, Pasqualini L, Verdecchia P, Mannarino E. Arterial wall thickening at different sites and its association with left ventricular hypertrophy in newly diagnosed essential hypertension. Am J Hypertens. 2000;13(4 Pt 1):324–31.CrossRef
32.
go back to reference Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens. 2012;26(6):343–9.CrossRef Cuspidi C, Sala C, Negri F, Mancia G, Morganti A. Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. J Hum Hypertens. 2012;26(6):343–9.CrossRef
33.
go back to reference Li H, Pei F, Shao L, Chen J, Sun K, Zhang X, et al. Prevalence and risk factors of abnormal left ventricular geometrical patterns in untreated hypertensive patients. BMC CardiovascDisord. 2014;66:14136. Li H, Pei F, Shao L, Chen J, Sun K, Zhang X, et al. Prevalence and risk factors of abnormal left ventricular geometrical patterns in untreated hypertensive patients. BMC CardiovascDisord. 2014;66:14136.
34.
go back to reference Carroll JD, Carroll EP, Feldman T, Ward DM, Lang RM, McGaughey D, et al. Sex-associated differences in left ventricular function in aortic stenosis of the elderly. Circulation. 1992;86(4):1099–107.CrossRef Carroll JD, Carroll EP, Feldman T, Ward DM, Lang RM, McGaughey D, et al. Sex-associated differences in left ventricular function in aortic stenosis of the elderly. Circulation. 1992;86(4):1099–107.CrossRef
35.
go back to reference Petrov G, Regitz-Zagrosek V, Lehmkuhl E, Krabatsch T, Dunkel A, Dandel M, et al. Regression of myocardial hypertrophy after aortic valve replacement: faster in women? Circulation. 2010;122(11 Suppl):S23-28.CrossRef Petrov G, Regitz-Zagrosek V, Lehmkuhl E, Krabatsch T, Dunkel A, Dandel M, et al. Regression of myocardial hypertrophy after aortic valve replacement: faster in women? Circulation. 2010;122(11 Suppl):S23-28.CrossRef
Metadata
Title
Risk factors for electrocardiographic left ventricular hypertrophy in a young Chinese general population: the Hanzhong adolescent cohort study
Authors
Yue-Yuan Liao
Ke Gao
Bo-Wen Fu
Lei Yang
Wen-Jing Zhu
Qiong Ma
Chao Chu
Yu Yan
Yang Wang
Wen-Ling Zheng
Jia-Wen Hu
Ke-Ke Wang
Yue Sun
Chen Chen
Jian-Jun Mu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-01966-y

Other articles of this Issue 1/2021

BMC Cardiovascular Disorders 1/2021 Go to the issue