Abstract 3267: Gender Difference in the Association of Aortic Valve Sclerosis and Cardiovascular Events in Hypertensive Adults with Left Ventricular Hypertrophy: The LIFE Study
Background: Aortic valve sclerosis (AVS) is known to be associated with cardiovascular (CV) events. Whether this association differs between hypertensive women and men with electrocardiographic (ECG) left ventricular hypertrophy (LVH) has not been assessed.
Methods: Hypertensive patients with LVH by Cornell voltage-duration product or Sokolow-Lyon voltage criteria on a screening ECG were randomized to losartan- or atenolol-based treatment and followed for 60 ± 4 months in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Analyses used echocardiographic and clinical parameters in the 960 participants in the LIFE echo substudy.
Results: At baseline evaluation, the presence of AVS in 392 (41.4%) of participants (39.3% women; 68 ± 7 years) was associated with older age, higher prevalence of CV disease and Framingham risk score (all p < 0.05), but not with gender, cholesterol level or urine albumin/creatinine ratio (all p < 0.05). In Cox regression analyses adjusting for significant covariates including the Framingham risk score, history of cardiovascular disease on baseline evaluation and randomized treatment, AVS predicted stroke (hazard ratio [HR] = 3.09, p < 0.05) only in female but not in male participants (p > 0.05). AVS predicted CV death (HR = 3.13, p < 0.005) and fatal myocardial infarction (MI) (HR = 3.11, p < 0.005) only in male but not in female participants (p > 0.05). The analyses also showed that the gender and AVS interaction was not significant for these events (all p > 0.05).
Conclusions: Among hypertensive patients with electrocardiographic LV hypertrophy, AVS independently predicts cardiovascular death and fatal MI, but not stroke in men, and predicts stroke but not CV death and fatal MI in women.