Longitudinal tracking of left ventricular mass over the adult life course: clinical correlates of short- and long-term change in the framingham offspring study.
BACKGROUND
Information is limited on the longitudinal tracking of left ventricular (LV) mass over the adult life course and the determinants of such change.


RESULTS
We used multilevel modeling to evaluate the correlates of LV mass prospectively over a 16-year period in 4217 Framingham study participants (mean age 45 years, 53% women) using up to 4 serial routine echocardiographic observations on each individual (11 762 observations). Age, sex, body mass index, systolic blood pressure, antihypertensive treatment, smoking, and diabetes mellitus were related to longitudinal measures of LV mass. Women and participants with diabetes mellitus experienced a steeper increase in LV mass with advancing age (compared with men and those without diabetes mellitus; P for interactions <0.0001 and 0.0003, respectively). Women also displayed greater increments in LV mass with increasing body mass index (compared with men, P=0.04 for interaction). Participants with optimal values of these risk factors experienced lesser increases in LV mass over time. Analyses evaluating short-term (4-year) changes in LV mass (2605 unique individuals providing 4494 observations) identified the same key determinants that influenced its long-term trajectory (ie, body mass index, sex, systolic blood pressure, antihypertensive treatment, and smoking).


CONCLUSIONS
Our longitudinal observations on a large community-based sample identified higher blood pressure, excess adiposity, smoking, and diabetes mellitus as fundamental determinants of LV mass tracking over the adult life course. These observations are consistent with the notion that maintenance of optimal levels of these risk factors in midlife will reduce the burden of LV hypertrophy, and possibly heart failure, in older age.
Lieb
Wolfgang
W
Framingham Heart Study, 73 Mount Wayte Ave, Framingham, MA 01702-5803, USA.
Xanthakis
Vanessa
V
Sullivan
Lisa M
LM
Aragam
Jayashri
J
Pencina
Michael J
MJ
Larson
Martin G
MG
Benjamin
Emelia J
EJ
Vasan
Ramachandran S
RS
D000328:Adult; D000368:Aged; D000375:Aging; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009929:Organ Size; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors