Obesity and Risk of Incident Left Ventricular Hypertrophy in Community‐Dwelling Populations With Hypertension: An Observational Study

Abstract

Background The aim of this study was to evaluate the association between obesity and risk of incident left ventricular hypertrophy (LVH) in community‐dwelling populations with hypertension and investigate whether this association would be attenuated by a lower achieved systolic blood pressure (SBP). Methods and 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.