Left ventricular hypertrophy offsets the sex difference in cardiovascular risk (the Campania Salute Network)

被引:68
|
作者
Gerdts, Eva [1 ,2 ]
Izzo, Raffaele [2 ,3 ]
Mancusi, Costantino [2 ,4 ]
Losi, Maria Angela [2 ,4 ]
Manzi, Maria Virginia [2 ,3 ]
Canciello, Grazia [2 ,3 ]
De Luca, Nicola [2 ,3 ]
Trimarco, Bruno [2 ,4 ]
de Simone, Giovanni [2 ,3 ]
机构
[1] Univ Bergen, Dept Clin Sci, Bergen, Norway
[2] Federico II Univ Hosp, Hypertens Res Ctr, Via S Pansini 5,Bld 1, I-80131 Naples, Italy
[3] Federico II Univ Hosp, Dept Translat Med Sci, Naples, Italy
[4] Federico II Univ Hosp, Dept Adv Biomed Sci, Naples, Italy
关键词
Sex; Left ventricular hypertrophy; Prognosis; Hypertension; CORONARY-HEART-DISEASE; END-POINT REDUCTION; SERUM URIC-ACID; TARGET ORGAN DAMAGE; LOSARTAN INTERVENTION; HYPERTENSIVE PATIENTS; ATRIAL-FIBRILLATION; FOLLOW-UP; WOMEN; OBESITY;
D O I
10.1016/j.ijcard.2017.12.086
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: In general, women have lower risk for cardiovascular disease. We tested whether this sex-specific protection persists also in the presence of hypertensive left ventricular hypertrophy (LVH). Methods: 12,329 women and men with hypertension and free from prevalent cardiovascular disease enrolled in the prospective Campania Salute Network registry were followed over a median of 4.1 years. Subjects were grouped according to the absence or the presence of LVH identified by echocardiography using validated sex-specific cut-off values of LV mass index (>47 g/m(2.7) in women and >50 g/m(2.7) in men). Main outcome was major cardiovascular events (MACE; combined acute coronary syndromes, stroke, hospitalization for heart failure and incident atrial fibrillation). Results: The cardiovascular risk profile accompanying LVH did not differ between sexes, but presence of obesity and diabetes carried higher probability for LVH in women, and LVH was more prevalent in women than men (43.4 vs. 32.1%, p < 0.001), Among patients without LVH (n = 7764), women had a 35% lower hazard rate (HR) for MACE (n = 179) than men (95% confidence interval [CI] 0.44-0.96, p = 0.031) in Cox regression analysis adjusting for cardiovascular risk factors and antihypertensive treatment during follow up. In contrast, among patients with LVH (n = 4565), women had a similar HR for MACE as men (HR 0.94 [95% CI 0.69-1.30], p = 0.720). Conclusion: This study demonstrates that presence of LVH in hypertension offsets the female sex-protection in cardiovascular risk. Thus among hypertensive subjects with LVH, women and men have comparable cardiovascular risk. (C) 2017 The Authors. Published by Elsevier Ireland Ltd.
引用
收藏
页码:257 / 261
页数:5
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