Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study

Article Abstract:

Enlargement (hypertrophy) of the left ventricle, the chamber of the heart that pumps blood to the body, appears to be associated with cardiovascular disease. Echocardiography, which uses ultrasound, is a more sensitive way than electrocardiography to assess left ventricular mass. To better characterize the relationship between ventricular size and heart disease, 3,220 participants in the well-known Framingham Heart Study were evaluated. All subjects were at least 40 years of age and were free of obvious cardiovascular disease. Subjects underwent physical examination, electrocardiography, and echocardiography. During a four-year follow-up, cardiovascular disease, death from cardiovascular disease, and death from any cause (all called 'disease events'), were recorded. Results showed that there were 113 new cardiovascular disease events for men and 95 for women during the follow-up period. Men with a left ventricular mass less than 90 grams per meter had a cardiovascular disease rate of 4.7 percent, while those with a mass greater than 140 grams per meter had a rate of 12.2. For women, the corresponding values were 4.1 percent and 16.1 percent. When mortality was adjusted for age, death rates for men in the lowest category (less than 90 grams per meter) were 4.1 percent, and 8.1 percent for men in the higher category; similar figures for women were 2.6 and 6.8 percent, respectively. In men, left ventricular hypertrophy was related to all three disease events, while for women it was only associated with an increased incidence of cardiovascular disease. The relative risk of cardiovascular disease for each increase of 50 grams per meter in left ventricular mass was 1.49 in men and 1.57 in women; for death from cardiovascular disease, 1.73 and 2.12, respectively; and for death from all causes, 1.49 and 2.01. It thus appears that determination of left ventricular mass by echocardiography is a good prognostic tool for predicting subsequent cardiovascular events, including death. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Prognosis, Heart diseases, Risk factors (Health), Hypertrophy, Framingham Heart Study

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The progression from hypertension to congestive heart failure

Article Abstract:

Chronic hypertension appears to be a strong risk factor for congestive heart failure (CHF). Researchers followed 5,143 men and women participating in the Framingham Heart Study and the Framingham Offspring Study for up to 20 years. Half of the participants had hypertension at the start of the study. During the study, 392 participants developed CHF. Ninety-one percent had hypertension at the start of the study. Eighty-two percent of the female CHF patients and 76% of the male CHF patients had stage 2 hypertension at the start of the study. Men with hypertension at the start of the study had twice the risk of CHF and women with hypertension had three times the risk. Half of the men and one-third of the women had a history of heart attack at the start of the study. Diabetes, enlargement of the left ventricle of the heart and heart valve disease at the start of the study also increased the risk of developing CHF.

Complications and side effects, Risk factors, Congestive heart failure

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Trends in the prevalence of hypertension, antihypertensive therapy, and left ventricular hypertrophy from 1950 to 1989

Article Abstract:

Antihypertensive drug treatment appears to have reduced the frequency of high blood pressure and also reduced the size of the left ventricle in patients who had an enlarged ventricle. Researchers coordinating the Framingham Heart Study analyzed the use of antihypertensive drugs, the frequency of hypertension, and the percentage of people with an enlarged left ventricle between 1950 and 1989. During that time, the use of antihypertensive drugs increased from less than 10% of the 10,333 patients to over one-fourth. The frequency of hypertension dropped from 20%-30% to less than 10% and the percentage of patients with an enlarged ventricle also decreased.

Statistics, Antihypertensive drugs, Antihypertensive agents

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