Association of Socioeconomic Disparities and Predisposing Factors with Higher Prevalence of Hypertension related Left Ventricular Hypertrophy in Males: a Malaysian Community-Based Study

Abstract

ABSTRACTLeft Ventricular Hypertrophy (LVH) is a risk for various cardiovascular events among those with hypertension (HT). However the prevalence of hypertension-related LVH (HT LVH+) in communities with lower socioeconomic status (SES) is not adequately reported. This study investigated the prevalence of HT LVH+ among the urban and rural males and the attributing factors. A total of 1,923 males who had echocardiographic examinations done were recruited. Their blood pressure was measured to diagnose those with or without hypertension. Left ventricular mass index was determined. Univariate analysis was performed to identify associated factors predisposing to LVH. A total of 992 males had HT, of which 264 had LVH, and were more prevalent in older age groups and Malays (p<0.001). Individuals from rural areas, with low income and low educational background were associated with higher LVH prevalence (p<0.001). Those with moderate aortic regurgitation was 3.17-fold higher in LVH. Ninety-nine normotensives had LVH, 71.7% came from rural. Total cholesterol and low density lipoprotein cholesterol levels were significantly higher in HT LVH+ from urban than the rural areas (p=0.029 and p=0.002, respectively). A quarter of the HT population in Malaysia develop LVH, majority of them were from rural, indicating that socioeconomic disparities contribute to the higher risk of HT LVH+. The rural populations may have attributed to different risk factors as opposed to those from urban, hence emphasize the need to deliver targeted strategies for prevention and management HT LVH+ by different SES.