Okin P M, Devereux R B, Jern S, Kjeldsen S E, Julius S, Dahlöf B
Department of Medicine, Division of Cardiology, Weill Medical College of Cornell University, New York, NY, USA.
Hypertension. 2000 Nov;36(5):766-73. doi: 10.1161/01.hyp.36.5.766.
The Losartan Intervention For Endpoint (LIFE) reduction in hypertension study is a double-blind, prospective, parallel group study designed to compare the effects of losartan with those of atenolol on the reduction of cardiovascular morbidity and mortality. A total of 9194 patients with hypertension and ECG left ventricular hypertrophy (LVH) by Cornell voltage-duration product and/or Sokolow-Lyon voltage criteria were enrolled in the study, with baseline clinical and ECG data available in 8785 patients (54% women; mean age, 67+/-7 years). ECG LVH by Cornell voltage-duration product criteria was present in 5791 patients (65.9%) and by Sokolow-Lyon voltage in 2025 patients (23.1%). Compared with patients without ECG LVH by Cornell voltage-duration product criteria, patients with ECG LVH by this method were older; more obese; more likely to be female, white, and to have never smoked; more likely to be diabetic and have angina; and had slightly higher systolic, diastolic, and pulse blood pressures. In contrast, patients with ECG LVH by Sokolow-Lyon criteria were slightly younger; less obese; more likely to be male, black, and current smokers; less likely to have diabetes; more likely to have angina and a history of cerebrovascular disease; and had higher systolic and pulse blood pressure but slightly lower diastolic blood pressure than patients without ECG LVH by this method. By use of multivariate logistic regression analyses, presence of ECG LVH by Cornell voltage-duration product criteria was predominantly associated with higher body mass index, increased age, and female gender, whereas presence of ECG LVH by Sokolow-Lyon voltage criteria was predominantly related to lower body mass index, male gender, and black race. Thus, hypertensive patients who meet Cornell product and Sokolow-Lyon voltage criteria are associated with different, but potentially equally adverse, risk factor profiles.
氯沙坦干预降低高血压终点事件(LIFE)研究是一项双盲、前瞻性、平行组研究,旨在比较氯沙坦与阿替洛尔在降低心血管发病率和死亡率方面的效果。共有9194例高血压患者和根据康奈尔电压-时限乘积和/或索科洛-里昂电压标准诊断为心电图左心室肥厚(LVH)的患者纳入该研究,8785例患者(54%为女性;平均年龄67±7岁)有基线临床和心电图数据。根据康奈尔电压-时限乘积标准诊断为心电图LVH的患者有5791例(65.9%),根据索科洛-里昂电压标准诊断为心电图LVH的患者有2025例(23.1%)。与不符合康奈尔电压-时限乘积标准心电图LVH的患者相比,符合该标准心电图LVH的患者年龄更大;更肥胖;更可能为女性、白人且从不吸烟;更可能患有糖尿病和心绞痛;收缩压、舒张压和脉压略高。相比之下,符合索科洛-里昂标准心电图LVH的患者年龄略小;肥胖程度较低;更可能为男性、黑人且为当前吸烟者;患糖尿病的可能性较小;更可能有心绞痛和脑血管疾病史;收缩压和脉压较高,但舒张压略低于不符合该标准心电图LVH的患者。通过多因素逻辑回归分析,康奈尔电压-时限乘积标准心电图LVH主要与较高的体重指数、年龄增加和女性性别相关,而索科洛-里昂电压标准心电图LVH主要与较低的体重指数、男性性别和黑人种族相关。因此,符合康奈尔乘积和索科洛-里昂电压标准的高血压患者与不同但可能同样不利的危险因素谱相关。