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Left ventricular hypertrophy and risk of fatal and non-fatal stroke. EUROSTROKE: a collaborative study among research centres in Europe
  1. M L Bots1,2,
  2. Y Nikitin3,
  3. J T Salonen4,
  4. P C Elwood5,
  5. S Malyutina3,
  6. A Freire de Concalves6,
  7. J Sivenius7,
  8. A Di Carlo8,
  9. P Lagiou9,
  10. J Tuomilehto10,
  11. P J Koudstaal11,
  12. D E Grobbee1,2
  1. 1Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, the Netherlands
  2. 2Julius Centre for Patient Oriented Research, University Medical Centre Utrecht, the Netherlands
  3. 3Russian Academy of Medical Sciences Siberian Branch, Institute of Internal Medicine, Novosibirsk, Russia
  4. 4Research Institute of Public Health, University of Kuopio, Kuopio, Finland
  5. 5MRC Epidemiology Unit, Llandough Hospital, Penarth, South Glamorgan, UK
  6. 6Neurology, Hospitais da Universidade de Coimbra, Coimbra, Portugal
  7. 7Department of Neurology, University of Kuopio, Kuopio, Finland
  8. 8National Research Council of Italy (CNR-CSFET) Italian Longitudinal study of Aging, Florence, Italy
  9. 9Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece
  10. 10Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
  11. 11Neurology, University Hospital Rotterdam Dijkzigt, Rotterdam, the Netherlands
  1. Correspondence to:
 Dr M L Bots, Julius Centre for General Practice and Patient Oriented Research, University Medical Centre Utrecht, room D01.335, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands;
 M.L.Bots{at}jc.azu.nl

Abstract

Background: This study investigated the association between electrocardiographically assessed left ventricular hypertrophy (LVH) and fatal, non-fatal, haemorrhagic and ischaemic stroke in four European cohorts participating in EUROSTROKE.

Methods: EUROSTROKE is a collaborative project among ongoing European cohort studies to investigate differences in incidence of, and risk factors for, stroke between countries. EUROSTROKE is designed as a nested case-control study. For each stroke case, two controls were sampled. Strokes were classified according to MONICA criteria or reviewed by a panel of four neurologists. LVH was assessed according to the Minnesota code or the automated diagnostic MEANS classification system. For this analysis, data on LVH and stroke were available from cohorts in Cardiff (84 cases/200 controls), Kuopio (60/116), Rotterdam (114/334), and Novosibirsk (62/168). Results are adjusted for age and sex.

Results: LVH was associated with a twofold increased risk of stroke (odds ratio 2.1 (95% CI 1.3 to 3.5). The risk was particularly pronounced for fatal stroke (4.0 (95% CI 2.1 to 7.9)), whereas the risk was non-significantly increased for non-fatal stroke (1.5 (95% CI 0.8 to 2.7)). The increased risk was more pronounced in smokers: for total stroke 3.5 (95% CI 1.5 to 8.1) versus 1.6 (95% CI 0.8 to 3.1) in non-smokers. Adjustment for systolic blood pressure and body mass index attenuated the associations. LVH was not preferentially associated with a particular type of stroke, although the association with cerebral infarction was stronger.

Conclusion: This analysis of the EUROSTROKE project indicates that LVH assessed by electrocardiogram is a predictor of stroke. The association seems to be stronger for fatal stroke than for non-fatal stroke and is more pronounced in smokers.

  • cohort
  • blood pressure
  • LVH
  • left ventricular hypertrophy

https://doi.org/10.1136/jech.56.suppl_1.i8

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    Footnotes

    • Funding: EUROSTROKE is supported by grant BMH1-CT93–1786 from the European Community BIOMED I programme and by grant CIPD-CT94–0256 from the European Community PECO programme.