Iso H, Kiyama M, Doi M, Nakanishi N, Kitamura A, Naito Y, Sato S, Iida M, Konishi M, Shimamoto T
Institute of Community Medicine, University of Tsukuba, Ibaraki-ken, Japan.
Circulation. 1994 Apr;89(4):1717-24. doi: 10.1161/01.cir.89.4.1717.
It has been suggested that echocardiographically determined left ventricular mass (LVM) is useful in the prediction of hypertension. To examine the relation between LVM and subsequent blood pressure (BP) change, a 6- to 8-year follow-up was conducted in adult Japanese men.
LVM was determined by M-mode echocardiography using the American Society of Echocardiography formula among 354 normotensive men aged 30 to 59 years from a rural community (n = 193) and from urban companies (n = 161) in Japan between 1979 and 1983. BP was remeasured 6 to 8 years after baseline in 148 rural men (77%) and 127 urban men (79%). For men whose BP was remeasured, the mean +/- SD LVM index (LVM/body surface area [g/m2]) at baseline was 117 +/- 22 in rural men and 99 +/- 15 in urban men (the difference, P < .001). For both populations, LVM index was positively associated with age and physical activity but not with body mass index. Associations of LVM index with usual alcohol intake and initial BPs were generally weak. According to linear regression analyses after controlling for these covariates at baseline, a 20-g/m2 greater LVM index at baseline was associated with a 5 mm Hg increase in systolic and a 4 mm Hg increase in diastolic BP during the subsequent 6 to 8 years for urban men. A 1-mm greater average ventricular wall thickness was associated with a similar BP increase. For rural men, positive associations of LVM index with BP increase existed but were weak. The weaker association between LVM index and BP increase in rural compared with urban men was probably the result of effects of higher physical activity, leading to a larger left ventricular internal dimension. The increase in systolic and diastolic BPs over the 6 to 8 years of observation was significantly related to baseline LVM index in rural and urban men with a smaller internal dimension (rural men, < or = 49 mm; urban men, < or = 47 mm) but not in those with larger dimensions.
An increased LVM index predicts subsequent BP increase in middle-aged normotensive men in the presence of a normal or small internal dimension.
有人提出，超声心动图测定的左心室质量（LVM）有助于预测高血压。为了研究LVM与后续血压（BP）变化之间的关系，对成年日本男性进行了6至8年的随访。
1979年至1983年间，在日本农村社区（n = 193）和城市公司（n = 161）中，对354名年龄在30至59岁的血压正常男性，使用美国超声心动图学会公式通过M型超声心动图测定LVM。在基线6至8年后，对148名农村男性（77%）和127名城市男性（79%）重新测量血压。对于重新测量血压的男性，农村男性基线时的平均±标准差LVM指数（LVM/体表面积[g/m²]）为117±22，城市男性为99±15（差异，P <.001）。对于这两个人群，LVM指数与年龄和身体活动呈正相关，但与体重指数无关。LVM指数与通常饮酒量和初始血压的关联一般较弱。在控制基线时的这些协变量后进行线性回归分析，基线时LVM指数每增加20 g/m²，城市男性在随后6至8年中收缩压升高5 mmHg，舒张压升高4 mmHg。平均心室壁厚度每增加1 mm，血压升高幅度相似。对于农村男性，LVM指数与血压升高存在正相关，但较弱。与城市男性相比，农村男性中LVM指数与血压升高之间的关联较弱，可能是由于身体活动量较大导致左心室内径较大的影响。在观察的6至8年中，收缩压和舒张压的升高与基线LVM指数在左心室内径较小的农村和城市男性中显著相关（农村男性，≤49 mm；城市男性，≤47 mm），但在左心室内径较大的男性中则不然。
在左心室内径正常或较小的情况下，LVM指数升高可预测中年血压正常男性随后的血压升高。
