RESULTS: We used the EMINCA (Echocardiographic Measurements in Normal Chinese Adults) criteria, which were derived from healthy Chinese populations to define LVH. A total of 2069 participants with hypertension and without LVH (obesity 20.4%) were included. The association between obesity and risk of incident LVH was evaluated using Cox proportional hazard models and stratified by achieved follow-up SBP levels (≥140, 130-139, and <130 mm Hg). These analyses were also assessed using the American Society of Echocardiography/European Association of Cardiovascular Imaging criteria, which were derived from European populations to define LVH. After a median follow-up of 2.90 years, the rates of incident LVH in the normal-weight, overweight, and obese groups were 13.5%, 20.3%, and 27.8%, respectively (P<0.001). In reference to normal weight, obesity was associated with increased risk of incident LVH (adjusted hazard ratio [aHR], 2.51 [95% CI, 1.91-3.29]), which was attenuated when achieved SBP was <130 mm Hg (aHR, 1.78 [95% CI, 0.99-3.19]). This association remained significant when achieved SBP was ≥140 mm Hg (aHR, 3.45 [95% CI, 2.13-5.58]) or at 130 to 139 mm Hg (aHR, 2.32 [95% CI, 1.23-4.36]). Differences in these findings were noted when LVH was defined by the American Society of Echocardiography/European Association of Cardiovascular Imaging criteria.
CONCLUSIONS: Obesity was associated with incident LVH and an SBP target <130 mm Hg might be needed to attenuate this risk in patients with hypertension and obesity.
结果:我们使用了EMINCA(正常中国成年人的超声心动图测量)标准,它们来自健康的中国人群来定义LVH。共纳入2069名患有高血压和无LVH(肥胖20.4%)的参与者。使用Cox比例风险模型评估肥胖与发生LVH的风险之间的关系,并通过获得的随访SBP水平(≥140、130-139和<130mmHg)进行分层。这些分析也使用美国超声心动图学会/欧洲心血管成像协会标准进行评估。它们来自欧洲人群来定义LVH。经过2.90年的中位随访,正常体重的LVH发生率,超重,肥胖组是13.5%,20.3%,27.8%,分别(P<0.001)。关于正常体重,肥胖与LVH事件风险增加相关(调整后的风险比[aHR],2.51[95%CI,1.91-3.29]),当达到的SBP<130mmHg(AHR,1.78[95%CI,0.99-3.19])。当达到SBP≥140mmHg时,这种关联仍然显著(aHR,3.45[95%CI,2.13-5.58])或130至139mmHg(aHR,2.32[95%CI,1.23-4.36])。当美国超声心动图学会/欧洲心血管成像协会标准定义LVH时,注意到这些发现的差异。
结论:肥胖与LVH相关,高血压和肥胖患者可能需要一个<130mmHg的SBP目标来降低这种风险。