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Left ventricular hypertrophy determined by Sokolow–Lyon criteria: a different predictor in women than in men?

Journal of Human Hypertension volume 20, pages 451–459 (2006)Cite this article

Abstract

The clinical usefulness of the Sokolow–Lyon voltage criteria in the assessment of electrocardiographic left ventricular hypertrophy (ECG LVH) is addressed. We prospectively studied 3338 women and 3330 men referred with hypertension, with an average follow-up of 11.2 years. The voltage amplitude sum SV1+max (RV5 or RV6) was calculated and ECG LVH was defined as a sum ⩾3.5 mV. We adjusted survival for age, treatment status before presentation and a previous myocardial infarction or cerebrovascular accident. The risk of stroke, coronary heart disease (CHD) and cardiovascular disease (CVD) mortality increased significantly for each quantitative 0.1 mV increase in baseline electrocardiogram (ECG) voltage, in women within the range of 1.6–3.9% and in men 1.4–3.0%. After further adjustments for race, body mass index, smoking and systolic blood pressure, increasing voltage independently predicted CVD mortality in both men and women. In women, both increasing voltage and the presence of left ventricular hypertrophy (LVH) were predictors of stroke mortality, whereas in men this risk was attenuated. In men, the adjusted association between increasing voltage and CHD mortality tended to be stronger than in women. The use of different thresholds for the two genders made little difference. For stroke and CHD mortality, the population attributable fractions associated with LVH were 15.2 and 5.4% in women and 12.8 and 8.5% in men, respectively. In conclusion, the greater the baseline ECG voltage sum, the greater the associated CVD mortality risk. Women tended to have a high risk of stroke mortality owing to LVH despite adjustments.

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Acknowledgements

This study was supported by grants from the Finnish Medical Foundation and the UK Department of Health and Social Security. The following also participated in the DHSS: Beilin LJ, Cohen A, Coles EC, Dollery CT, Fletcher AE, Jeffers TA, Ledingham JGG, Munro-Faure AD, Petrie JC, Robb OJ, Rossiter C, Rylance PB, Struthers A. From general practice: Davies JB, Douglas-Jones AP, Grant D, Horder E, Kenworthy-Browne JM.

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Authors and Affiliations

  1. Imperial College Faculty of Medicine, London, UK

    R L Antikainen, T Grodzicki, A J Palmer & C J Bulpitt

  2. Department of Internal Medicine, University of Oulu and Oulu City Hospital, Oulu, Finland

    R L Antikainen

  3. Jagiellonian University, Cracow, Poland

    T Grodzicki

  4. City Hospital, Birmingham, UK

    D G Beevers

  5. Aberdeen Royal Infirmary, Aberdeen, UK

    J Webster

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  1. R L Antikainen
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for The Department of Health and Social Security Hypertension Care Computer Project (DHCCP)

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Correspondence to R L Antikainen.

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Antikainen, R., Grodzicki, T., Palmer, A. et al. Left ventricular hypertrophy determined by Sokolow–Lyon criteria: a different predictor in women than in men?. J Hum Hypertens 20, 451–459 (2006). https://doi.org/10.1038/sj.jhh.1002006

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