Abstract 1936: Cornell Product Left Ventricular Hypertrophy In Electrocardiogram Is A Strong Predictor Of Stroke In Community-dwelling Japanese Normotensives
Background: Incidence of stroke is higher than ischemic heart disease in Japanese. Left ventricular hypertrophy (LVH) is associated with an increased risk for stroke among hypertensives. We evaluated the risk of LVH among normotensives (SBP/DBP<120/80 mmHg) subjects.
Methods: In a Japanese general population, 10755 subjects who were undertaken electrocardiogram and measured BP at baseline were evaluated Cornell product (CP) and Sokolow-Lyon (SL) voltage as markers of LVH (CP≥2440 mm ms and SL voltage>35 mm). Follow-up was performed for 10 years and incidence of stroke was evaluated.
Results: Prevalence of CP-LVH were 2.7% for normotensives, 5.2 % for prehypertensives, 11.0 % for hypertensives, and that of SL-LVH were 8.6%, 11.4%, and 22.5%, respectively. In overall subjects, CP-LVH and SL-LVH were independent predictors of stroke [CP-LVH: hazard risk (HR) 1.65, 95% confidence interval (CI) 1.22–2.25, SL-LVH: HR 1.30, 95%CI 1.02–1.65] after adjustment for confounding factors. In Cox regression analysis in each stage of hypertension, hazard ratios of stroke in subjects with CP-LVH were higher among normotensives (HR 8.28, 95%CI 3.72–18.41) than among prehypertensives (HR 1.56, 95%CI 0.67–3.63) and hypertensives (HR 1.48, 95%CI 1.02–2.13) (Figure⇓), although that in subjects with SL-LVH were not significant (normotensives: HR 1.54, 95%CI 0.70–3.40, prehypertensives: HR 1.29, 95%CI 0.72–2.32, hypertensives: HR 1.21, 95%CI 0.90–1.62).
Conclusion: The ECG-LVH independently predicted future stroke in a Japanese general population. The specificity of the Cornell product-LVH is higher than that of Sokolow-Lyon-LVH especially among normotensive subjects <120/80 mmHg.