Circulation, Vol 89, 1041-1050, Copyright © 1994 by American Heart Association
M Kupari, P Koskinen and J Virolainen
BACKGROUND: Echocardiographically determined left ventricular (LV) mass
predicts adverse cardiovascular events in the general population. We have
assessed the correlates of LV mass in a population-based study focusing on
lifestyle and salt intake. METHODS AND RESULTS: A random sample of 120
persons born in 1954 was invited; 93 (42 men) entered the study. The
subjects' physical activity and alcohol, tobacco, and coffee consumption
were quantified by 2-month dairy follow-up, and sodium intake was
quantified by 7-day food records. Blood pressure was averaged for casual
cuff measurements made 2 months apart. LV mass was determined by M-mode
echocardiography, and stroke volume was determined by Doppler. Hematocrit
and serum insulin were measured. In multiple linear regression analysis, LV
mass was related positively and independently (P < .05) to body weight,
systolic blood pressure, stroke volume, sodium intake, hematocrit, and
energy expenditure in leisure- time physical activity. Additional analyses
showed that the relation of LV mass to daily sodium intake depended on
blood pressure (P < .001 for the interaction); the multiple regression
coefficient (+/- SE) was 0.41 +/- 0.11 g.mEq-1 x d-1 (P = .001) in subjects
with systolic blood pressure above the population median but statistically
nonsignificant (- 0.15 +/- 0.10 g.mEq-1 x d-1) in those with lower blood
pressure. LV mass was clearly elevated only in persons with both blood
pressure and sodium intake above the population medians. CONCLUSIONS: Body
weight, blood pressure, stroke volume, sodium intake, physical activity,
and hematocrit are independent predictors of LV mass among unselected
persons aged 36 to 37 years. The synergistic interaction of dietary salt
with blood pressure suggests that high sodium intake may sensitize the
heart to the hypertrophic stimulus of pressure load. Prospective studies
are needed to confirm these cross-sectional associations.
ARTICLES
Correlates of left ventricular mass in a population sample aged 36 to 37 years. Focus on lifestyle and salt intake
Division of Cardiology (First Department of Medicine), Helsinki University Central Hospital, Finland.
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