title: Left ventricular hypertrophy and risk of fatal and non-fatal stroke. EUROSTROKE: a collaborative study among research centres in Europe.
abstract: BACKGROUND
  This study investigated the association between electrocardiographically assessed left ventricular hypertrophy (LVH) and fatal, non-fatal, haemorrhagic and ischaemic stroke in four European cohorts participating in EUROSTROKE.
  
  
  METHODS
  EUROSTROKE is a collaborative project among ongoing European cohort studies to investigate differences in incidence of, and risk factors for, stroke between countries. EUROSTROKE is designed as a nested case-control study. For each stroke case, two controls were sampled. Strokes were classified according to MONICA criteria or reviewed by a panel of four neurologists. LVH was assessed according to the Minnesota code or the automated diagnostic MEANS classification system. For this analysis, data on LVH and stroke were available from cohorts in Cardiff (84 cases/200 controls), Kuopio (60/116), Rotterdam (114/334), and Novosibirsk (62/168). Results are adjusted for age and sex.
  
  
  RESULTS
  LVH was associated with a twofold increased risk of stroke (odds ratio 2.1 (95% CI 1.3 to 3.5). The risk was particularly pronounced for fatal stroke (4.0 (95% CI 2.1 to 7.9)), whereas the risk was non-significantly increased for non-fatal stroke (1.5 (95% CI 0.8 to 2.7)). The increased risk was more pronounced in smokers: for total stroke 3.5 (95% CI 1.5 to 8.1) versus 1.6 (95% CI 0.8 to 3.1) in non-smokers. Adjustment for systolic blood pressure and body mass index attenuated the associations. LVH was not preferentially associated with a particular type of stroke, although the association with cerebral infarction was stronger.
  
  
  CONCLUSIONS
  This analysis of the EUROSTROKE project indicates that LVH assessed by electrocardiogram is a predictor of stroke. The association seems to be stronger for fatal stroke than for non-fatal stroke and is more pronounced in smokers.
authors.affiliation: Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands. M.L.Bots@jc.azu.nl
authors.forename: M L
authors.initials: ML
authors.lastname: Bots
authors.forename: Y
authors.initials: Y
authors.lastname: Nikitin
authors.forename: J T
authors.initials: JT
authors.lastname: Salonen
authors.forename: P C
authors.initials: PC
authors.lastname: Elwood
authors.forename: S
authors.initials: S
authors.lastname: Malyutina
authors.forename: A
authors.initials: A
authors.lastname: Freire de Concalves
authors.forename: J
authors.initials: J
authors.lastname: Sivenius
authors.forename: A
authors.initials: A
authors.lastname: Di Carlo
authors.forename: P
authors.initials: P
authors.lastname: Lagiou
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016208:Databases, Factual; D004562:Electrocardiography; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality