Association of Left Ventricular Hypertrophy with Hemoglobin Levels in Nonanemic and Anemic Populations

Abstract

Introduction: It is established that anemia leads to adaptive changes in cardiac geometry including left ventricular hypertrophy (LVH). However, published data are still scarce regarding the association of LVH with normal-range hemoglobin levels. Objective: To evaluate the association between hemoglobin level and LVH in subjects with or without anemia. Methods: The study included 48,034 Korean men and women who received echocardiography during their medical health checkup. They were divided into 4 groups according to their hemoglobin concentration (g/dL) in men (<14, 14–14.9, 15–15.9, and ≥16) and women (<12, 12–12.9, 13–13.9, and ≥15). Multivariate logistic regression analysis was used to calculate adjusted ORs and 95% CI for LVH in each group compared with the group with the lowest hemoglobin. Subgroup analysis was conducted for subjects within normal hemoglobin levels. Results: There was an inverse relationship between hemoglobin levels and LVH, where unadjusted and adjusted ORs and 95% CI for LVH decreased with increasing hemoglobin levels in both men and women. In subgroup analysis, this inverse relationship was also observed in subjects with hemoglobin in the nonanemic range. Conclusion: The decrease in hemoglobin was significantly associated with the increased probability of LVH, and this association was found even in nonanemic subjects.