Skip Navigation

European Heart Journal 1999 20(6):429-438; doi:10.1053/euhj.1998.1314
Copyright © 1999 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (30)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Schirmer, H.
Right arrow Articles by Rasmussen, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schirmer, H.
Right arrow Articles by Rasmussen, K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Prevalence of left ventricular hypertrophy in a general population; The Tromsø Study

H. Schirmera,f1, P. Lundea and K. Rasmussenb

a Institute of Community Medicine, University of Tromsø Tromsø Norway
b Institute of Clinical Medicine, University of Tromsø Tromsø Norway

revised August 29, 1998; accepted September 2, 1998

Abstract

Aims

Left ventricular hypertrophy has been shown to be an independent predictor of cardiovascular morbidity. Acknowledging the skewed distribution of left ventricular mass, we wanted to develop criteria for left ventricular hypertrophy based on percentiles of left ventricular mass, and observe the effect on estimates of left ventricular hypertrophyprevalences in different subgroups and on the relationship to cardiovascular risk factors in a general population.

Methods and Results

In a population-based sample of 3287 subjects aged 25–85 years, left ventricular mass was estimated using M-mode echocardiography. A ‘healthy’ subgroup was used as a reference sample to define sex-specific left ventricular hypertrophy criteria. Sex-specific 97·5 percentiles for left ventricular mass by height, based on the reference sample, were 145·5 and 125·4g.m–1, for men and women, respectively. The prevalences of left ventricular hypertrophy in the total population were 14·9% for men and 9·1% for women. The main independent predictors of left ventricular hypertrophy were male gender, body mass index, systolic blood pressure, valvular heart disease, cardiovascular disease and antihypertensive medication. Body mass index and systolic blood pressure had a strong synergistic association with left ventricular hypertrophy in men, but not in women.

Conclusion

An alternative framework for defining left ventricular hypertrophy is provided. Body mass index is the culprit factor for risk of left ventricular hypertrophy. Our study indicates that weight reduction is a relevant measure for treatment and possibly prevention of left ventricular hypertrophy in a substantial part of the general population.

Key Words: Hypertrophy, population, echocardiography, obesity, hypertension, sex

f1 Correspondence: Henrik Schirmer, MD, Institute of Community Medicine, University of Tromsø, 9037 Tromsø, Norway.

References

  1. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561–1566[Abstract]
  2. Messerli FH, Schmieder R. Left ventricular hypertrophy. A cardiovascular risk factor in essential hypertension. Drugs. 1986;31:192–201
  3. Muiesan ML, Salvetti M, Rizzoni D, Castellano M, Donato F, Agabiti RE. Association of change in left ventricular mass with prognosis during long-term antihypertensive treatment. J Hypertens. 1995;13:1091–1095[CrossRef][ISI][Medline]
  4. Verdecchia P, Schillaci G, Borgioni C. Prognostic significance of serial changes in left ventricular mass in essential hypertension. Circulation. 1998;97:48–54[Abstract/Free Full Text]
  5. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55:613–618[Abstract/Free Full Text]
  6. Woythaler JN, Singer SL, Kwan OL. Accuracy of echocardiography versus electrocardiography in detecting left ventricular hypertrophy: comparison with postmortem mass measurements. J Am Coll Cardiol. 1983;2:305–311[Abstract]
  7. Devereux RB, Pini R, Aurigemma GP, Roman MJ. Measurement of left ventricular mass: Methodology and expertise. J Hypertens. 1997;15:801–809[CrossRef][ISI][Medline]
  8. Bjartveit K, Foss OP, Gjervig T, Lund-Larsen PG. The Cardiovascular Disease Study. Acta Med Scand. 1979;:1–70
  9. Thelle DS, Førde OH, Try K, Lehmann EH. The Tromsø heart study. Methods and main results of the cross-sectional study. Acta Med Scand. 1976;200:107–118[ISI][Medline]
  10. Bønaa KH, Thelle DS. Association between blood pressure and serum lipids in a population. The Tromsø Study. Circulation. 1991;83:1305–1314[Abstract/Free Full Text]
  11. Bønaa KH, Arnesen E. Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study. Circulation. 1992;86:394–405[Abstract/Free Full Text]
  12. Stensland-Bugge E, Bønaa KH, Joakimsen O. Reproducibility of ultrasonographically determined intima-media thickness is dependent on arterial wall thickness. The Tromsø Study. Stroke. 1997;28:1972–1980[Abstract/Free Full Text]
  13. O’Rourke RA, Hanrath P, Henry WN. Report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on Recommendations for Standardization of Measurements from M-mode Echocardiograms. Circulation. 1984;69:854A–857A
  14. Devereux RB, Alonso DR, Lutas EM. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57:450–458[CrossRef][ISI][Medline]
  15. Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelli WP. Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol. 1987;59:956–960[CrossRef][ISI][Medline]
  16. Lindberg W, Natvig H, Rygh A, Svendsen K. Height and weight screening in adult men and women; A proposal to new Norwegian middle weigh by height tables. Tidsskr Nor Lægeforen. 1956;11:361–368
  17. SAS/STAT User’s Guide. Version 6, Fourth Ed. Cary: SAS Institute Inc; 1990.
  18. Zanchetti A, Chalmers J, Arakawa K. IX-1993 Guidelines for management of mild hypertension. Memorandum from a WHO/ISH meeting. Clin Exp Hypertens. 1993;22:1392–1395
  19. MacMahon SW, Wilcken DE, Macdonald GJ. The effect of weight reduction on left ventricular mass. A randomized controlled trial in young, overweight hypertensive patients. N Engl J Med. 1986;314:334–339[Abstract]
  20. Liebson PR, Grandits GA, Dianzumba S. Comparison of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional-hygienic therapy in the Treatment of Mild Hypertension Study (TOMHS). Circulation. 1995;91:698–706[Abstract/Free Full Text]
  21. Messerli FH, Sundgaard Riise K, Reisin ED. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med. 1983;99:757–761[ISI][Medline]
  22. Hammond IW, Devereux RB, Alderman MH, Laragh JH. Relation of blood pressure and body build to left ventricular mass in normotensive and hypertensive employed adults. J Am Coll Cardiol. 1988;12:996–1004[Abstract]
  23. Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry. The Framingham Heart Study. JAMA. 1991;266:231–236[Abstract]
  24. Lauer MS, Anderson KM, Levy D. Separate and joint influences of obesity and mild hypertension on left ventricular mass and geometry: the Framingham Heart Study. J Am Coll Cardiol. 1992;19:130–134[Abstract]
  25. Gottdiener JS, Reda DJ, Materson BJ. Importance of obesity, race and age to the cardiac structural and functional effects of hypertension. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. J Am Coll Cardiol. 1994;24:1492–1498[Abstract]
  26. Liebson PR, Grandits G, Prineas R. Echocardiographic correlates of left ventricular structure among 844 mildly hypertensive men and women in the Treatment of Mild Hypertension Study (TOMHS). Circulation. 1993;87:476–486[Abstract/Free Full Text]
  27. Lindroos M, Kupari M, Heikkila J, Tilvis R. Echocardiographic evidence of left ventricular hypertrophy in a general aged population. Am J Cardiol. 1994;74:385–390[CrossRef][ISI][Medline]
  28. Grandits GA, Liebson PR, Dianzumba S, Prineas RJ. Echocardiography in multicenter clinical trials: experience from the Treatment of Mild Hypertension Study. Control Clin Trials. 1994;15:395–410[CrossRef][ISI][Medline]
  29. Selmer R. Blood pressure and twenty-year mortality in the City of Bergen, Norway. Am J Epidemiol. 1992;136:428–440[Abstract/Free Full Text]
  30. Stevens J, Jianwen C, Pamuk ER, Williamson DF, Thun MJ, Woods JL. The effect of age on the association between body mass index and mortality. N Engl J Med. 1998;338:1–7[Abstract/Free Full Text]
  31. Seidell JC, Verschuren WMM, van Leer EM, Kromhout D. Overweight, underweight, and mortality. A prospective study of 48287 men and women. Arch Intern Med. 1996;156:958–963[Abstract]
  32. Causes of Death 1994. Oslo/Kongsvinger: Statistics Norway; 1997.
  33. Vasan RS, Larson MG, Levy D, Evans JC, Benjamin EJ. Distribution and categorization of echocardiographic measurements in relation to reference limits: the Framingham Heart Study: formulation of a height- and sex-specific classification and its prospective validation. Circulation. 1997;96:1863–1873[Abstract/Free Full Text]
  34. Manolio TA, Levy D, Garrison RJ, Castelli WP, Kannel WB. Relation of alcohol intake to left ventricular mass: The Framingham Study. J Am Coll Cardiol. 1991;17:717–721[Abstract]
  35. Dannenberg AL, Levy D, Garrison RJ. Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol. 1989;64:1066–1068[CrossRef][ISI][Medline]
  36. Kannel WB, Brand N, Skinner JJ Jr, Dawber TR, McNamara PM. The relation of adiposity to blood pressure and development of hypertension. The Framingham study. Ann Intern Med. 1967;67:48–59[ISI][Medline]
  37. Kuller LH, Crook M, Almes MJ, Detre K, Reese G, Rutan G. Dormont High School (Pittsburgh, Pennsylvania) blood pressure study. Hypertension. 1980;2:109–116[Abstract]
  38. Higgins MW, Keller JB, Metzner HL, Moore FE, Ostrander-LD J. Studies of blood pressure in Tecumseh, Michigan. II. Antecedents in childhood of high blood pressure in young adults. Hypertension. 1980;2:117–123[Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
M J. S Zaman, J. Sanders, A. M Crook, G. Feder, M. Shipley, A. Timmis, and H. Hemingway
Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography
Heart, April 1, 2007; 93(4): 491 - 494.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
M. Dorr, B. Wolff, D. M. Robinson, U. John, J. Ludemann, W. Meng, S. B. Felix, and H. Volzke
The Association of Thyroid Function with Cardiac Mass and Left Ventricular Hypertrophy
J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 673 - 677.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
M.D. Witham, J.I. Davies, A. Dawson, P.G. Davey, and A.D. Struthers
Hypothetical economic analysis of screening for left ventricular hypertrophy in high-risk normotensive populations
QJM, February 1, 2004; 97(2): 87 - 93.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
F.N Saleh, H Schirmer, J Sundsfjord, and R Jorde
Parathyroid hormone and left ventricular hypertrophy
Eur. Heart J., November 2, 2003; 24(22): 2054 - 2060.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
H Schirmer, P Lunde, and K Rasmussen
Mitral flow derived Doppler indices of left ventricular diastolic function in a general population. The Tromso study
Eur. Heart J., August 2, 2000; 21(16): 1376 - 1386.
[Abstract] [PDF]

Home page
 Eur Heart JHome page
E. Edmunds, C.G.C. Spencer, and G.Y.H. Lip
Left ventricular hypertrophy in the population.
Eur. Heart J., October 1, 1999; 20(20): 1514 - 1515.
[PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (30)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Schirmer, H.
Right arrow Articles by Rasmussen, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schirmer, H.
Right arrow Articles by Rasmussen, K.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?