The prognostic characteristics of hypertensive left ventricular hypertrophy in a population with low prevalence of hypertension and low plasma cholesterol.

One hundred and twenty-six hypertensive patients with ECG left ventricular hypertrophy (HT-LVH) were followed for 10 years to investigate the prognostic characteristics in a population with low prevalence of hypertension (2.93%) and low plasma cholesterol (4.26 +/- 0.91 mmol/L). A cohort of age-, sex-, region- and occupation-matched, randomized hypertensives without ECG-LVH (n = 163) and normotensives (n = 275) served as controls. HT-LVH was found to be associated with an increased risk of overall death, stroke mortality and cardiovascular mortality. The major cause of death in rural hypertensives with ECG-LVH was stroke (56.8%). After adjusting BP and BP stratification, no significant difference of stroke risk was found between patients with and without LVH, while cardiovascular risk persisted in patients with LVH plus ST segment depression. LVH per se did not appear to be an independent factor for stroke death. Higher stroke mortality in patients with LVH may be ascribed to the coexisting higher level of BP. Furthermore, after adjusting for the coexisting hypertension, ECG-LVH in terms of voltage only was not related to the prognosis of stroke and cardiovascular death. The mortality rate of stroke was not affected by plasma cholesterol levels, as the levels seen were in a low range.