Sakboonyarat Boonsub, Poovieng Jaturon, Rangsin Ram
Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
Pulmonary and Critical Care Division, Department of Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
Clin Hypertens. 2024 Apr 1;30(1):8. doi: 10.1186/s40885-024-00267-8.
Left ventricular hypertrophy (LVH) strongly predicts cardiovascular diseases (CVD) and death. One-fourth of Thai adults suffer from hypertension. Nevertheless, the information on LVH among Thai patients with hypertension is not well characterized. We aimed to identify the prevalence and factors associated with electrocardiographic LVH (ECG-LVH) among patients with hypertension in Thailand.
The present study obtained the dataset from the Thailand Diabetes Mellitus/Hypertension study, which included hypertension patients aged 20 years and older receiving continuous care at outpatient clinics in hospitals nationwide in 2011-2015 and 2018. Meanwhile, those without a record of 12-lead electrocardiography (ECG) were excluded from the analysis. ECG-LVH was defined as the LVH noted regarding ECG interpretation in the medical records. Multivariable logistic regression analysis was utilized for determining factors associated with ECG-LVH and presented as the adjusted odds ratio (AOR) and 95% confidence interval (CI).
From 226,420 hypertensive patients in the Thailand Diabetes Mellitus/Hypertension study, 38,807 individuals (17.1%) with ECG data recorded were included in the analysis. The mean age was 64.8 ± 11.5 years, and 62.2% were women. Overall, 1,557 study participants had ECG-LVH, with an estimated prevalence of 4.0% (95% CI, 3.8-4.2%). Age-adjusted ECG-LVH prevalence among women and men was 3.4 and 5.1%, respectively (P < 0.001). Multivariable analysis determined factors associated with ECG-LVH, including being men (AOR, 1.49; 95% CI, 1.31-1.69), individuals aged 70 to 79 years (AOR, 1.56; 95% CI, 1.20-2.02) and ≥ 80 years (AOR, 2.10; 95% CI, 1.58-2.78) compared to individuals aged less than 50 years, current smokers (AOR, 1.26; 95% CI, 1.09-1.46) compared to those who never smoked, systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg (AOR, 1.58; 95% CI, 1.30-1.92) compared to systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg.
The current study illustrated the prevalence of ECG-LVH among Thai patients with hypertension who had ECG recorded and identified high-risk groups who tended to have ECG-LVH. The findings underscore the need for targeted interventions, particularly among high-risk groups such as older individuals, men, and current smokers, to address modifiable factors associated with ECG-LVH.
左心室肥厚（LVH）是心血管疾病（CVD）和死亡的有力预测指标。四分之一的泰国成年人患有高血压。然而，泰国高血压患者中左心室肥厚的相关信息尚不明确。我们旨在确定泰国高血压患者中心电图左心室肥厚（ECG-LVH）的患病率及相关因素。
本研究从泰国糖尿病/高血压研究中获取数据集，该研究纳入了2011 - 2015年及2018年在全国医院门诊接受持续治疗的20岁及以上高血压患者。同时，将无12导联心电图（ECG）记录的患者排除在分析之外。ECG-LVH定义为病历中根据心电图解读记录的左心室肥厚。采用多变量逻辑回归分析确定与ECG-LVH相关的因素，并以调整后的优势比（AOR）和95%置信区间（CI）表示。
在泰国糖尿病/高血压研究的226,420例高血压患者中，38,807例（17.1%）有ECG数据记录并纳入分析。平均年龄为64.8 ± 11.5岁，女性占62.2%。总体而言，1557名研究参与者有ECG-LVH，估计患病率为4.0%（95% CI，3.8 - 4.2%）。年龄调整后，女性和男性的ECG-LVH患病率分别为3.4%和5.1%（P < 0.001）。多变量分析确定了与ECG-LVH相关的因素，包括男性（AOR，1.49；95% CI，1.31 - 1.69），70至79岁个体（AOR，1.56；95% CI，1.20 - 2.02）及≥80岁个体（AOR，2.10；95% CI，1.58 - 2.78）与年龄小于50岁个体相比，当前吸烟者（AOR，1.26；95% CI，1.09 - 1.46）与从不吸烟者相比，收缩压≥140 mmHg和舒张压≥90 mmHg（AOR，1.58；95% CI，1.30 - 1.92）与收缩压<140 mmHg和舒张压<90 mmHg相比。
本研究阐明了有ECG记录的泰国高血压患者中ECG-LVH的患病率，并确定了倾向于发生ECG-LVH的高危人群。研究结果强调了针对性干预的必要性，特别是在老年个体、男性和当前吸烟者等高风险人群中，以解决与ECG-LVH相关的可改变因素。
