title: Left ventricular hypertrophy detection and body mass index in essential hypertension.
abstract: OBJECTIVE
  Weight and height are two major determinants of left ventricular mass (LVM); the anthropometric parameter to which LVM should be normalized remains, however, debated. In a population of hypertensives, we compared the prevalence of left ventricular hypertrophy (LVH) defined by two indexation criteria of LVM in different subgroups of body mass index (BMI).
  
  
  METHODS
  A total of 4468 essential hypertensives included in the Evaluation of Target Organ Damage in Hypertension (ETODH), were divided in four groups according to BMI thresholds: lean (BMI<20 kg/m(2), 4.5%), normal (20-24.9 kg/m(2), 36.5%), overweight (25-29.9 kg/m(2), 41.9%) and obese (≥ 30 kg/m(2), 17.1%). All patients underwent quantitative echocardiography; LVH was defined by two criteria of LVM indexation: (A) ≥ 116 g/m(2) in men and ≥ 96 g/m(2) in women; (B) ≥ 49 g/m(2.7) in men and ≥ 45 g/m(2.7) in women.
  
  
  RESULTS
  Overall, 44.9% of the patients were found to have LVH by criterion A, 48.2% by criterion B and 37.0% by both criteria. Prevalence rates of LVH in the four BMI groups were 34.3%, 40.5%, 47.3%, 53.9% by criterion A, 19.8%, 37.0%, 53.6%, 69.7% by criterion B, and 14.2%, 30.9%, 41.5%, 47.8% by both criteria, respectively (p at least <0.05 for all).
  
  
  CONCLUSIONS
  Our findings show that LVH prevalence in both overweight and obese hypertensives is higher when LVM is normalized to height(2.7) compared with body surface area (BSA), whereas the opposite trend occurs in normal weight/lean hypertensives. Thus, the risk related to LVH is underestimated when the LVH/height(2.7) criterion is applied to lean/normal weight individuals and the LVH/BSA criterion in overweight/obese individuals.
authors.affiliation: Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Valentina
authors.initials: V
authors.lastname: Giudici
authors.forename: Laura
authors.initials: L
authors.lastname: Lonati
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.forename: Cristiana
authors.initials: C
authors.lastname: Valerio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence