title: Age related prevalence of severe left ventricular hypertrophy in essential hypertension: echocardiographic findings from the ETODH study.
abstract: OBJECTIVE
  We sought to investigate the prevalence and correlates of severe left ventricular hypertrophy (LVH) in relation to age in a large cohort of essential hypertensives referred to a single outpatient hypertension clinic.
  
  
  METHODS
  A total of 3752 (mean age 53±13 years, 53% men) untreated (29.5%) and treated hypertensive patients categorized in three age groups (I: 18-40 years; II: 41-64 years; III: ≥65 years) were considered for this analysis. All patients underwent extensive investigations searching for target organ damage. LVH, defined as LV mass ≥49/45 g/m(2.7) in men/women, respectively, was graded as mild, moderate and severe according to Lang's report.
  
  
  RESULTS
  LVH prevalence was 29.4% in group I, 48.2% in group II and 63.6% in group III. Overall, more than one fourth of patients with LVH had a severely increased LV mass index; the likelihood of having severe LVH was two- and four-fold higher in elderly hypertensives than in their middle-aged and young counterparts, respectively. Increasing age and LVH degree were both associated with a greater prevalence of concentric LV geometry as well as of extra-cardiac organ damage (i.e. carotid intima-media thickness).
  
  
  CONCLUSIONS
  LVH is a highly prevalent organ damage in essential hypertensives, particularly in the elderly, who exhibited a more severe increase of LV mass index, higher relative wall thickness and extra-cardiac organ damage compared with young and middle-aged sub-groups. Our findings suggest that the assessment of cardiovascular risk by grading LVH rather than simply defining the presence/absence of this cardiac phenotype could improve therapeutic strategies in the hypertensive population, particularly in the elderly.
authors.affiliation: Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy. cesare.cuspidi@unimib.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Stefano
authors.initials: S
authors.lastname: Meani
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.forename: Cristiana
authors.initials: C
authors.lastname: Valerio
authors.forename: Francesca
authors.initials: F
authors.lastname: Negri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult