Provincial Key Laboratory of Coronary Heart Disease Prevention, Department of Cardiology, Guangdong Cardiovascular institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
J Clin Lab Anal. 2021 Mar;35(3):e23688. doi: 10.1002/jcla.23688. Epub 2021 Jan 2.
Distinct populations differ in LVH prevalence and impaired LV geometry. Currently, the prevalence of and risk factors for LV geometric patterns in Chinese hypertensives administered irbesartan have not been specifically addressed in large studies.
Totally 10,883 patients (6623 men and 4260 women) completed the survey, including 1181 hypertensives administered irbesartan (488 males and 693 females) that were finally enrolled. Based on LVMI and RWT derived from comprehensive echocardiography, the LV geometric patterns of irbesartan-treated hypertensive individuals were classified into four types, including the normal, concentric remodeling, and concentric and eccentric hypertrophy groups. Logistic regression analysis was applied in males and females, respectively, for determining odds ratios (ORs) and 95% confidence intervals (CIs) for various potential risk factors for abnormal LV geometrical patterns in irbesartan-treated hypertensives.
The clinical and echocardiographic data differed significantly between males and females. The prevalence rates of concentric remodeling, concentric hypertrophy, and eccentric hypertrophy were 36.3%, 15.4%, and 6.1% in males, respectively, and 23.5%, 20.3%, and 23.8% in females, accordingly. Gender, daily dose of irbesartan, BMI, SBP, WtHR, and neck-circumference were significantly associated with LV geometric patterns. After adjustment for confounding factors, risk factors for LVH and impaired LV geometry included SBP, WtHR in males, and MAU-Cr and WtHR in females.
LVH and impaired LV geometric patterns are more prevalent in females (67.7%) compared with that in males (57.8%) among hypertensives upon irbesartan administration. For such population, risk factors beyond elevated blood pressure may be involved in the progression of LVH and impaired LV geometric patterns in both genders.
不同人群左心室肥厚（LVH）的患病率和左心室几何形状受损的情况存在差异。目前，在大型研究中尚未专门探讨接受厄贝沙坦治疗的中国高血压患者的 LV 几何形态的患病率和危险因素。
共有 10883 名患者（6623 名男性和 4260 名女性）完成了这项调查，其中包括最终纳入的 1181 名接受厄贝沙坦治疗的高血压患者（488 名男性和 693 名女性）。根据综合超声心动图得出的左心室质量指数（LVMI）和相对室壁厚度（RWT），将接受厄贝沙坦治疗的高血压患者的 LV 几何形态分为 4 种类型，包括正常、同心重构、同心和偏心肥厚组。分别对男性和女性进行 logistic 回归分析，以确定厄贝沙坦治疗的高血压患者中各种潜在的异常 LV 几何形态危险因素的比值比（OR）和 95%置信区间（CI）。
男性和女性的临床和超声心动图数据存在显著差异。男性中，同心重构、同心肥厚和偏心肥厚的患病率分别为 36.3%、15.4%和 6.1%，而女性中分别为 23.5%、20.3%和 23.8%。性别、厄贝沙坦的日剂量、体重指数（BMI）、收缩压（SBP）、体重指数与腰围的比值（WtHR）和颈围与身高的比值（neck-circumference）与 LV 几何形态显著相关。在调整混杂因素后，LVH 和 LV 几何形状受损的危险因素包括 SBP、男性中的 WtHR，以及女性中的微量白蛋白尿与肌酐比值（MAU-Cr）和 WtHR。
在接受厄贝沙坦治疗的高血压患者中，LVH 和 LV 几何形状受损在女性（67.7%）中比男性（57.8%）更为常见。对于这一人群，除了血压升高之外，可能还有其他危险因素参与了两性 LVH 和 LV 几何形状受损的进展。
