THE PREVALENCE AND CORRELATES OF ECHOCARDIOGRAPHIC LEFT-VENTRICULAR HYPERTROPHY AMONG EMPLOYED PATIENTS WITH UNCOMPLICATED HYPERTENSION
THE PREVALENCE AND CORRELATES OF ECHOCARDIOGRAPHIC LEFT-VENTRICULAR HYPERTROPHY AMONG EMPLOYED PATIENTS WITH UNCOMPLICATED HYPERTENSION
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DOI：
10.1016/s0735-1097(86)80476-4
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发表时间：
1986-03-01
影响因子：
24
通讯作者：
LARAGH, JH
中科院分区：
文献类型：
--
作者：
HAMMOND, IW;DEVEREUX, RB;LARAGH, JH
为了确定超声心动图左心室肥厚在普通人群中的患病率及其相关性，我们研究了621名受试者。根据世界卫生组织的标准，在基于工作场所的治疗计划中，无并发症的高血压患者包括145名临界高血压患者和316名持续性高血压患者。血压正常的受试者是从同一联盟的成员中随机选择的。用M型超声心动图测量左心室内径，计算左心室重量及其他左心室解剖指标。超声心动图测定了13种左室肥厚指标在正常血压人群中的特异性，并用每种标准评价了临界性或持续性高血压患者左室肥厚的发生率。结果表明，在不同性别的城市人群中，检测左心室肥厚最合适的参考标准是以性别为界值的左心室重量指数，女性为110 g/m2或以上，男性为134 g/m2或以上。根据这些标准，97%的特异度显示，临界性高血压患者中左室肥厚的患病率约为12%，相对轻度、无并发症的持续性高血压患者中约为20%。壁厚测量的表现略逊于此。在相似的血压水平下，黑人患者比白人患者更容易表现出向心性左心室肥厚，特别是在交界性高血压患者中。持续性高血压患者的左心室肥厚也表现为心输出量增加，与血浆肾素活性降低密切相关。
To determine the prevalence and correlates of echocardiographic left ventricular hypertrophy among subjects in a general population, we studied 621 employed subjects. Patients with uncomplicated essential hypertension in a worksite-based treatment program included 145 with borderline hypertension and 316 with sustained hypertension by World Health Organization criteria. Normotensive subjects were randomly selected from members of the same unions. M-mode echocardiographic left ventricular dimensions were used to calculate left ventricular mass and other indexes of left ventricular anatomy. The specificity of 13 echocardiographic criteria of left ventricular hypertrophy was determined in normotensive individuals, and the prevalence of left ventricular hypertrophy by each criterion was assessed in patients with borderline or sustained essential hypertension. The results suggest that the most suitable reference standard for detection of left ventricular hypertrophy in a heterogeneous urban population utilizes sex-specific cutoff values for left ventricular mass index of 110 g/m2 or greater for women and 134 g/m2 or greater for men. With 97% specificity, the prevalence of left ventricular hypertrophy by these criteria is approximately 12% among patients with borderline hypertension and 20% among patients with relatively mild, uncomplicated sustained essential hypertension. Wall thickness measurements performed slightly less well. At similar levels of blood pressure, black patients were more likely than white patients to exhibit concentric left ventricular hypertrophy, especially among borderline hypertensive patients. Left ventricular hypertrophy occurred in patients with sustained hypertension who also exhibited increased cardiac output, strongly associated with low plasma renin activity.