Factors Associated with Left Ventricular Hypertrophy on ECG in Middle-aged Normotensive Healthy Men

Chung, Ju Hye; Song, Chan Hee

Abstract

BACKGROUND
This study was designed to elucidate which factors affected left ventricular hypertrophy (LVH) on ECG in middle-aged normotensive healthy men.
METHODS
A total of 436 normotensive office workers who visited the health examination center of St. Mary's Hospital of Catholic University in Korea from August 1 to October 30, 2002, were divided into two groups; 138 with LVH on ECG were grouped as LVH and 298 who showed no LVH on ECG were grouped as non-LVH. Questionnaires on history of smoking, drinking and exercise were filled out, and body fat, body mass index, blood pressure and biochemical markers were measured. Related factors with LVH on ECG were statistically analyzed with Chi-square test, t-test and logistic regression.
RESULTS
The mean systolic and diastolic blood pressure and mean alcohol intake (g/day) were significantly elevated in the LVH group (P<0.005). The non-LVH group had a tendency to show increased pulse rate (P=0.058), a higher percentage of people who did not exercise at all, and a lower percentage of people who exercised regularly (P=0.056). The smoking history, BMI and other biochemical markers showed no significant differences (P>0.1). On logistic regression analysis, there was a significant increase in odds ratio for LVH with increase in diastolic blood pressure (adjusted OR 1.048, 95% CI 1.019~1.077), with exercise more than 3 times a week (adjusted OR 2.317, 95% CI 1.258~4.269) and with increased alcohol intake (adjusted OR 1.010, 95% CI 1.001~1.019). In contrast, odds ratio for LVH decreased as the pulse rate per minute increased (adjusted OR 0.974, 95% CI 0.952~0.997). In detailed analysis comparing those who exercised regularly more than 3 times a week with those who exercised less than 3 times a week, the increase in diastolic blood pressure was a significant factor which increased the odds ratio for LVH in both groups. A significant increase in the odds ratio by mean alcohol intake per day was shown only in a group who exercised less than 3 times a week.
CONCLUSION
As a result of this study, in normotensive middle-aged men with LVH on ECG, patients should be monitored for regular exercise and increase in diastolic blood pressure should be regarded as a risk factor for LVH on ECG irrespective of exercise. In those who do not do exercise regularly, diastolic blood pressure as well as alcohol intake should be evaluated as risk factors for LVH