Hypertension Clinical Trial
Official title:
Relationship of Different Electrocardiographic Parameters and Ambulatory Blood Pressure Parameters to Detect Left Ventricular Hypertrophy
To review the accuracy of electrocardiography in screening for left ventricular hypertrophy in patients with hypertension.
Arterial hypertension is a major cause of coronary heart disease, stroke, and heart failure.
Several studies have shown that left ventricular hypertrophy is an important risk factor in
patients with hypertension, leading to a fivefold to 10-fold increase in cardiovascular
risk,1 2 3 4 5 which is similar to the increase seen in patients with a history of myocardial
infarction.6 The presence of left ventricular hypertrophy, in addition to hypertension, thus
has important implications for assessing risk and managing patients, including decisions on
interventions other than antihypertensive treatment, such as lipid lowering treatment and
lifestyle modifications.7 8 Accurate and early diagnosis of left ventricular hypertrophy is
therefore an important component of the care of patients with hypertension.
Decisions about treatment should be based on assessments of hypertensive target organ damage
and overall cardiovascular risk. The appropriate diagnostic work-up of suspected left
ventricular hypertrophy in patients with hypertension is less clear, however. There is many
electrocardiographic indexes for the diagnosis of left ventricular hypertrophy, based on the
standard 12 lead electrocardiogram, have been described. Many of the proposed indexes have
remained anecdotal, but others are commonly used, including the Sokolow-Lyon index,9 the
Cornell voltage index,10 the Cornell product index,11 the Gubner index,12 and the
Romhilt-Estes scores.13 However, debate about their comparative diagnostic value continues.14
15 We did a systematic review to clarify the accuracy of different electrocardiographic
indexes, with emphasis on their ability to rule out left ventricular hypertrophy in patients
with arterial hypertension.
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