Abstract 14537: Association of Cardiovascular Risk Factors with Incident ECG-LVH and Increasing LVMI in a Biracial Population: Coronary Artery Risk Development in Young Adults (CARDIA) Study
Background: Electrocardiographic left ventricular hypertrophy (ECG-LVH) is a significant independent predictor of Cardiovascular Disease (CVD) events. Data are sparse regarding risk factors associated with incident ECG-LVH in young adults. We sought to examine the prospective association of traditional CVD risk factors with development of incident ECG-LVH and increasing LV mass index (LVMI) in the biracial CARDIA cohort.
Methods: We studied participants who attended the Year 0 (1985-86) and 20 examinations from the CARDIA cohort, which included measurement of traditional CVD risk factors and 12-lead ECGs. ECGs were coded for LVH using Cornell Product (CP) criteria and race and sex-specific LVMI. Multivariate logistic regression analyses were fitted using incident ECG-LVH or increase in ECG-LVMI by 1 SD as the outcomes of interest. In separate analyses, we examined both baseline values of covariates or all values averaged between Year 0 and 20.
Results: The study sample consisted of 2532 participants, average age 25 years at year 0 (44% black and 57% women). Black men and women were significantly more likely to develop ECG-LVH by CP (6.3% and 5.8%, respectively) between Year 0 and 20 than white men and women (2.4% and 1.9%, respectively), all P<0.05. Incident development of ECG-LVH by CP was associated with male sex, higher CP at year 0, higher average DBP and treatment for hypertension. Increase in LVMI by 1 SD from year 0 to 20 (Table) was associated with higher average fasting insulin, higher average BMI, higher average DBP, and inversely associated with fitness (average treadmill duration).
Conclusions: Black men and women have significantly higher rates of incident ECG-LVH than whites. This study suggests that increasing LVMI during young adulthood is associated with higher levels of insulin, higher BMI, and lower fitness. Further investigation is needed to determine the association of obesity, insulin resistance and exercise capacity with increasing LV mass.
- © 2010 by American Heart Association, Inc.