title: Electrocardiographic left ventricular hypertrophy and arterial stiffness: the Ohasama study.
abstract: BACKGROUND
  Whether arterial stiffness per se contributes to left ventricular hypertrophy (LVH) independently of blood pressure (BP) remains unknown. We examined the relationship between pulse wave velocity (PWV) and LVH in a large population.
  
  
  METHODS
  The PWV was measured between the brachial and ankle regions (baPWV) of 798 individuals. We diagnosed LVH using electrocardiographic criteria: Cornell voltage-duration product >2440 mm x msec or Sokolow-Lyon voltage >38 mm. The participants were initially separated into those with and without LVH [LVH(+) and LVH(-) groups, respectively]. To determine theoretical baPWV, we first constructed a nomogram for the LVH(-) group, calculated the PWV index (measured baPWV - theoretical baPWV) for each individual and then compared the two groups. We also examined the factors associated with LVH(+) using multivariate analyses.
  
  
  RESULTS
  Linear regression analysis revealed that the theoretical baPWV (m/sec) = 0.20 x age (years) + 0.13 x Mean arterial pressure (MAP) (mm Hg) + 0.05 x Heart rate (beats/min) - 11.74 (R(2) = 0.56). The PWV index was greater in the LVH(+) than in the LVH(-) group (P = .025). The baPWV was independently related to LVH(+) along with MAP, medication for hypertension, and for diabetes; a 1 SD (4.3 m/sec) increase in baPWV was associated with a 26% increase in the risk of LVH(+) (P = .022). When LVH(+) risk factors were defined as hypertension, diabetes, and high baPWV (> or =14.6 m/sec), the prevalence of LVH(+) linearly increased with the number of concomitant LVH(+) risk factors (P < .001).
  
  
  CONCLUSIONS
  Arterial stiffness is independently related to electrocardiographically determined LVH in the general population.
authors.affiliation: Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Aoba, Aramaki, Sendai, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watabe
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Rieko
authors.initials: R
authors.lastname: Hatanaka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Hanazawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ohba
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000503:physiopathology; D004548:Elasticity; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D016017:Odds Ratio; D015995:Prevalence; D011673:Pulsatile Flow; D012372:ROC Curve; D012307:Risk Factors