Kuch B, Muscholl M, Luchner A, Döring A, Riegger G A, Schunkert H, Hense H W
Institut für Epidemiologie und Sozialmedizin Arbeitsgruppe Klinische Epidemiologie Universität Münster.
Z Kardiol. 1996 May;85(5):334-42.
Overweight and hypertension are considered to be independent contributors to the development of left ventricular hypertrophy (LVH). We investigated a selected subgroup (n = 520, aged 52 to 67 years) of participants from the MONICA Augsburg cohort to assess gender-specificity of left ventricular adaptation in response to increasing weight and blood pressure degrees. M-mode-echocardiographic measurements were made and calculated according to the Penn-convention in 293 women and 227 men. LVH was defined as left ventricular mass indexed to height (LVMIm) > 143 g/m in men and > 102 g/m in women (Framingham criteria). Men and women were comparable with regard to increase in LVMIm from the lowest weight and blood pressure group to the highest groups, respectively. In men the increase in LVMIm was 31% from lean to severely obese subjects (111 vs. 145 g/m, p < 0.003) and 25% from normotensive to treated hypertensive subjects (116 vs. 145 g/m, p < 0.0001); in women respective values were 36% (83 vs. 113 g/m, p < 0.0001) and 27% (88 vs. 112 g/m, p < 0.0001). The combined occurrence of obesity and hypertension had an additional effect on left ventricular mass, which was much more pronounced in women than in men. In particular, the increase in LVMIm from the group of lean normotensives to the group of severely obese treated hypertensives was 85% (72 g/m vs. 133 g/m, p < 0.0001) in women and 49% (96 g/m vs. 144 g/m, p < 0.002) in men (p-value for the gender-interaction term < 0.05). The odds ratio for the LVH-prevalence in hypertensive obese subjects as opposed to normal weight normotensive subjects were 11.9 (p < 0.0001) in women and 4.9 (p < 0.0004) in men. In conclusion, we observed for both genders independently and similarly pronounced effects of hypertension and obesity. The combined occurrence of hypertension and obesity had an additional impact on left ventricular mass and hypertrophy, however, in women the effects were significantly more pronounced than in men. The data underscore the effects of hypertension and obesity in the development of LVH. In addition, gender specific factors seem to modulate the effects of these risk factors on left ventricular mass.
超重和高血压被认为是导致左心室肥厚（LVH）的独立因素。我们从奥格斯堡MONICA队列研究的参与者中选取了一个亚组（n = 520，年龄52至67岁），以评估体重和血压升高时左心室适应性的性别特异性。对293名女性和227名男性进行了M型超声心动图测量，并根据宾夕法尼亚公约进行计算。LVH定义为男性身高校正后的左心室质量（LVMIm）> 143 g/m²，女性> 102 g/m²（弗明汉标准）。男性和女性从最低体重和血压组到最高组的LVMIm增加情况具有可比性。在男性中，从瘦到重度肥胖受试者LVMIm增加了31%（111 vs. 145 g/m²，p < 0.003），从血压正常到接受治疗的高血压受试者增加了25%（116 vs. 145 g/m²，p < 0.0001）；在女性中，相应的值分别为36%（83 vs. 113 g/m²，p < 0.0001）和27%（88 vs. 112 g/m²，p < 0.0001）。肥胖和高血压同时存在对左心室质量有额外影响，在女性中比在男性中更为明显。特别是，从瘦的血压正常者组到重度肥胖的接受治疗的高血压者组，女性的LVMIm增加了85%（72 g/m² vs. 133 g/m²，p < 0.0001），男性增加了49%（96 g/m² vs. 144 g/m²，p < 0.002）（性别交互项的p值< 0.05）。高血压肥胖受试者与正常体重血压正常受试者相比，LVH患病率的比值比在女性中为11.9（p < 0.0001），在男性中为4.9（p < 0.0004）。总之，我们观察到高血压和肥胖对男女两性均有独立且相似的显著影响。然而，高血压和肥胖同时存在对左心室质量和肥厚有额外影响，在女性中的影响明显比男性更为显著。这些数据强调了高血压和肥胖在LVH发生发展中的作用。此外，性别特异性因素似乎调节了这些危险因素对左心室质量的影响。
