Regional differences in the prevalence of left ventricular hypertrophy within Germany.
BACKGROUND
There are considerable regional disparities in the prevalence of cardiovascular risk factors within Germany. We undertook this study to investigate differences in the prevalence of left ventricular hypertrophy (LVH) between northeast and southwest Germany.


METHODS
Data from two population-based studies, Kooperative Gesundheitsforschung im Raum Augsburg (KORA) conducted in southwest and Study of Health in Pomerania (SHIP) conducted in northeast Germany, were utilized. The study population comprised 2,516 women and men (835 from KORA and 1,681 from SHIP) aged 45-74 years who had no history of myocardial infarction. Echocardiograms were obtained according to standard protocols. Left ventricular mass (LVM), left ventricular mass indexed for body height, and left ventricular hypertrophy were used as dependent variables in multivariable analyses.


RESULTS
SHIP participants had higher LVM and left ventricular mass index values compared with KORA participants. These differences remained after analyses were adjusted for major confounders including obesity and hypertension. Consequently, there were higher proportions of LVH in SHIP compared with KORA across all 10-year age groups. Multivariable logistic regression revealed that the odds for LVH in participants living in northeast Germany were higher in women and men, respectively, by 1.57 (95% confidence interval: 1.18-2.09) and 1.68 (95% confidence interval: 1.25-2.27) than in participants living in southwest Germany. Potential methodological differences between studies do not seem to account for these findings.


CONCLUSIONS
There is a higher prevalence of LVH in northeast compared with southwest Germany. Regional disparities in hypertension and overweight only partly explain this difference.
Institute for Community Medicine, Ernst Moritz Arndt University, Greifswald, Germany. voelzke@uni-greifswald.de
Henry
H
Völzke
Jan
J
Stritzke
Bernhard
B
Kuch
Carsten O
CO
Schmidt
Jan
J
Lüdemann
Angela
A
Döring
Heribert
H
Schunkert
Hans-Werner
HW
Hense
D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014463:Ultrasonography