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PREVALENCE OF LEFT VENTRICULAR HYPERTROPHY AND ITS ASSOCIATED FACTORS AMONG HYPERTENSIVE PATIENTS IN AN OUTPATIENT CLINIC: PP.22.386

Background: Left ventricular hypertrophy (LVH) due to hypertension is associated with increased morbidity and mortality. Little is known about its prevalence in hypertensive patients in Malaysia. Objectives: The aim of this study was to determine the prevalence of LVH and its associated factors amongst hypertensive patients attending the primary care clinic at the University of Malaya Medical Centre. Methods: A cross-sectional study was conducted amongst all hypertensive patients attending the clinic from 1st June to 31st July 2009 following an Ethics committee's approval. Patients’ socio-demographic data, blood pressure (BP) and anthropometric measurements were captured. All patients had an electrocardiogram and a 2D-echocardiography. LVH was defined as when both left ventricular posterior wall and inter-ventricular septal thickness added together was greater than 11 mm on echocardiography. The Sokolow-Lyon criteria was used for ECG diagnosis of LVH. Metabolic syndrome was defined based on the NCEP 2004. Results: 411 subjects entered the study. The response rate was 59.2%. The mean age was 61.0 years (range 28 -70 years) .58.9% were females and 41% males. 78.8% were overweight or obese. 51.1% had metabolic syndrome The mean systolic BP was 136 mmHg (SD 14, range 95–190 mmHg) and mean diastolic BP 82 mmHg (SD 8, range 50–105 mmHg). 57.7% had good BP control. The prevalence of LVH was 4.4 % (N = 18) based on ECG and 24% (N = 86) based on echocardiography. Male (OR 1.95 CI 1.13, 3.38) and Metabolic syndrome (OR 2.5 CI 1.43, 4.39) had significant positive relation with LVH whereas the odds of LVH was significantly less when one had a home blood pressure monitor (OR 0.54 CI 0.31, 0.94) Conclusion: Prevalence of LVH was high amongst the hypertensive population in the primary care clinic. ECG while used widely in hypertensives, failed to detect LVH in the majority of the patients who had target organ damage. In view of the high prevalence of LVH every effort should be made to detect it early.