Abstract P016: Left Ventricular Hypertrophy is Associated With Incident Dementia: The Atherosclerosis Risk in Communities - Neurocognitive Study
Background: Left ventricular hypertrophy (LVH) is most commonly an indicator of target organ damage due to hypertension and may serve as a marker for chronicity of blood pressure elevation and as an indicator of the long-term burden of vascular risk factors. We assessed whether LVH measured by 12-lead ECG was associated with incident dementia in the Atherosclerosis Risk in Communities – Neurocognitive Study (ARIC-NCS).
Methods: Our analysis included 12,665 individuals (23% black race, 56% female, mean age 57) who attended visit 2 in 1990-92. Cornell voltage (SV3 + RaVL) was derived from 12-lead ECG at visit 2 (1990-92), visit 3 (1993-95) and visit 4 (1996-98) as a continuous variable, and the gender-specific Cornell voltage criteria (SV3 + RaVL > 28mm for men, and >22mm for women) was used to define LVH as a dichotomous variable. Incident dementia was defined using a validated algorithm consisting of a full neuropsychological assessment, interviews, informant interviews, hospital discharge codes, or diagnostic codes from death certificates. A cox proportional hazards model was used to evaluate the association between LVH and incident dementia. LVH and Cornell voltage were modeled as time-dependent variables and covariates were updated at each visit. Follow-up time was from baseline until date of dementia, end of follow-up, or the end of 2013, whichever came first.
Results: During a mean follow-up of 18 years, we identified 544 participants with LVH and 1195 incident dementia cases. LVH was associated with a higher risk of dementia: multivariable hazard ratio (HR) 1.91, 95% confidence interval (CI) 1.48-2.46 (Table). A 1-standard deviation increase in Cornell voltage (5 mm) was associated with a higher risk of dementia, HR (95% CI) = 1.10 (1.04-1.17).
Conclusion: In this large population-based study, LVH measured in mid-life was associated with an increased risk of dementia. Additional research should confirm this association, and these results underscore the need for hypertension control to prevent subclinical brain injury.
Author Disclosures: F.L. Norby: None. L.Y. Chen: None. E.Z. Soliman: None. R.F. Gottesman: None. T.H. Mosley: None. A. Alonso: None.
This research has received full or partial funding support from the American Heart Association, National Center.
- © 2017 by American Heart Association, Inc.