(Circulation. 1995;92:805-810.)
© 1995 American Heart Association, Inc.
Articles |
Left Ventricular Hypertrophy Has a Greater Impact on Survival in Women Than in Men
From the Department of Preventive Medicine and Epidemiology (Y.L., R.S.C., D.L.M.), Loyola University Medical Center, Maywood, Ill, and the Division of Cardiology (G.A.M.), Vanderbilt University School of Medicine, Nashville, Tenn.
Correspondence to Dr Youlian Liao, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153. E-mail YLIAO@LUCCPUA.IT.LUC.EDU.
Background Echocardiographically determined left ventricular hypertrophy (LVH) has a well-demonstrated association with cardiovascular morbidity and mortality. However, whether or not there is a sex differential in the impact of LVH on mortality has never been systematically explored.
Methods and Results This study enrolled 436 consecutive black
patients (163 men and 273 women) free of angiographic coronary
artery disease from a hospital registry. LVH (left
ventricular [LV] mass/body surface area 
117
g/m2 in men and 104 g/m2 in women) was
present in 84 men (52%) and 119 women (44%). During a mean of 5
years' follow-up (range, 0 to 9), 49 patients (26 men and 23 women)
died. The mortality rate was 5.40 per 100 patient-years in men with LVH
and 2.58 in men without LVH (crude relative risk [RR]=2.09)
and 3.21
and 0.66, respectively, in women (RR=4.87). In Cox regression
analysis, adjusting for age, hypertension, and ejection
fraction, the RR of total death for LVH versus non-LVH was 2.0 (95%
confidence interval [CI], 0.8 to 5.0) in men and 4.3 (95% CI, 1.6 to
11.7) in women. For cardiac death, RR was 1.3 (95% CI, 0.4 to 3.7) and
7.5 (95% CI, 1.6 to 33.8) in men and women, respectively.
Analyses using LV mass indexed by height or
height2.7 with the use of different LVH cut points,
comparing patients in the highest sex-specific tertile of mass index to
those in the lower two tertiles, and the use of LV mass indexes as
continuous variables similarly demonstrated a greater increase in
risk of either fatal end point among women than men.
Conclusions These findings indicate a sex difference in the contribution of LV mass and hypertrophy to mortality in the absence of coronary artery disease.
Key Words: hypertrophy • risk factors • coronary disease
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