| Left bundle branch block and cardiovascular morbidity and mortality in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint Reduction in Hypertension study. | |
| | |
MedLine Citation:
|
PMID: 18475164 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Whether left bundle branch block is associated with cardiovascular events in hypertension with electrocardiographic left ventricular hypertrophy is unknown. METHODS: Hypertensive patients with electrocardiographic-left ventricular hypertrophy were randomized to losartan-based or atenolol-based treatment and followed for 4.8 years in the losartan intervention for endpoint reduction in hypertension study. Cox regression models controlling for significant covariates assessed the association of left bundle branch block with cardiovascular events. RESULTS: At baseline, 564 patients had left bundle branch block and 8567 patients did not. Left bundle branch block was associated with higher heart rate, electrocardiographic-left ventricular hypertrophy, and prior cardiovascular disease (all P < 0.005). In univariate Cox regression analysis, left bundle branch block was not associated with the composite endpoint, stroke, or myocardial infarction (all P > 0.05), and was associated with cardiovascular (8.3 versus 4.5%, P < 0.001) and all-cause mortality (12.1 versus 8.6%, P < 0.005). After adjusting for significant covariates Cox regression analyses showed that left bundle branch block was independently associated with 1.6-fold more cardiovascular death (95% confidence interval 1.12-2.27, P < 0.05), 1.7 fold more hospitalization for heart failure (95% confidence interval 1.15-2.56, P < 0.01), 3.5 fold more cardiovascular death within 1 h (95% confidence interval 1.89-6.63, P < 0.001), and 3.4 fold more cardiovascular death within 24 h (95% confidence interval 1.83-6.35, P < 0.001). CONCLUSION: In hypertension with electrocardiographic-left ventricular hypertrophy, left bundle branch block identifies patients at increased risk of cardiovascular mortality, sudden cardiovascular death, and heart failure. |
| | |
Authors:
|
Zhibin Li; Björn Dahlöf; Peter M Okin; Sverre E Kjeldsen; Kristian Wachtell; Hans Ibsen; Markku S Nieminen; Sverker Jern; Richard B Devereux |
Related Documents
:
|
6883644 - Reduced space constant in slowly conducting regions of chronically infarcted canine myo... 1235334 - Intraventricular blocks in acute myocardial infarction. 15907824 - Knockout of the neural and heart expressed gene hf-1b results in apical deficits of ven... 837514 - De subitaneis mortibus. xxiii. rheumatoid arthritis and ankylosing spondylitis. 18804744 - Prevalence of different gadolinium enhancement patterns in patients after heart transpl... 1715124 - Effects of enflurane on inducibility of ventricular tachycardia. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: Journal of hypertension Volume: 26 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 2008 Jun |
Date Detail:
|
Created Date: 2008-05-13 Completed Date: 2008-07-29 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
|
Languages: eng Pagination: 1244-9 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Weill Cornell Medical College, New York, NY 10021, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00338260 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Antihypertensive Agents / therapeutic use Atenolol / therapeutic use Bundle-Branch Block / complications, diagnosis, mortality* Electrocardiography Female Humans Hypertension / complications, drug therapy, mortality* Hypertrophy, Left Ventricular / complications, drug therapy, mortality* Losartan / therapeutic use Male Middle Aged Prognosis |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents; 114798-26-4/Losartan; 29122-68-7/Atenolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Aortic stiffness and the balance between cardiac oxygen supply and demand: the Rotterdam Study.
Next Document: Laboratory tests as predictors of the antihypertensive effects of amlodipine, bisoprolol, hydrochlor...