title: Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values.
abstract: OBJECTIVE
  Previous studies have shown that left ventricular hypertrophy (LVH) represents a cardiovascular risk factor independently of clinic blood pressure (BP). The present study was aimed at determining the impact of LVH on the incidence of cardiovascular morbid and fatal events taking into account not only classical risk factors but also home and ambulatory BP values, which have been shown to have an important independent prognostic impact.
  
  
  METHODS
  In 1716 patients belonging to the 'Pressioni Arteriose Monitorate E Loro Associazioni' population of Monza, we quantified left ventricular mass index and identified LVH by standard cutoff values. We also measured clinic, home and 24-h ambulatory BPs together with serum glucose and lipids.
  
  
  RESULTS
  During a follow-up of 148 months, the rate of fatal and nonfatal (hospitalizations) cardiovascular events as well as of all-cause death was markedly greater (four-fold to five-fold) in patients as compared with those without LVH. In LVH individuals, the increased risk remained significant even when data were adjusted for a large number of other confounding factors including home BP, 24-h mean BP and ambulatory BP. Results were similar when left ventricular mass was indexed by height and body surface area. A 10% increase in left ventricular mass index was associated with a significant increase in cardiovascular risk or all-cause deaths. In multivariate analysis, left ventricular mass index was always an independent predictor of cardiovascular events and death for any cause.
  
  
  CONCLUSIONS
  Our data provide evidence that LVH is an important risk factor even when the contribution of different BPs to risk is fully taken into account.
authors: Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Monza (Milan), Italy.
authors: Michele
authors: M
authors: Bombelli
authors: Rita
authors: R
authors: Facchetti
authors: Stefano
authors: S
authors: Carugo
authors: Fabiana
authors: F
authors: Madotto
authors: Francesca
authors: F
authors: Arenare
authors: Fosca
authors: F
authors: Quarti-Trevano
authors: Anna
authors: A
authors: Capra
authors: Cristina
authors: C
authors: Giannattasio
authors: Raffaella
authors: R
authors: Dell'Oro
authors: Guido
authors: G
authors: Grassi
authors: Roberto
authors: R
authors: Sega
authors: Giuseppe
authors: G
authors: Mancia
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000401:mortality / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D012307:Risk Factors; D015996:Survival Rate