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Sex‐differences in prevalence of electrocardiographic left ventricular hypertrophy in Type 2 diabetes: The Casale Monferrato Study
Author(s) -
Bruno G.,
Giunti S.,
Bargero G.,
Ferrero S.,
Pagano G.,
Perin P. Cavallo
Publication year - 2004
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01246.x
Subject(s) - medicine , left ventricular hypertrophy , diabetes mellitus , cardiology , population , blood pressure , cohort , type 2 diabetes , albuminuria , endocrinology , environmental health
Aims Although left ventricular hypertrophy (LVH) defined by either standard 12‐lead ECG or echocardiography strongly predicts cardiovascular mortality, its prevalence in Type 2 diabetes is largely unknown. We have assessed prevalence of ECG‐LVH and its relationship with clinical and metabolic variables in an Italian population‐based cohort of subjects with Type 2 diabetes. Methods The study‐base was 965 (61.3%) subjects with Type 2 diabetes of the population‐based cohort living in Casale Monferrato (Italy). LVH was defined by ECG Cornell voltage‐duration product. All measurements were centralized. Results ECG‐LVH was diagnosed in 165/965 subjects, giving a prevalence of 17.1% (95% CI 14.7–19.5). Large sex differences were found, with higher prevalence in women (23.5%, 19.9–27.0) than in men (8.4%, 5.6–11.0), even after adjustment for age, BMI and hypertension (OR 3.83, 95% CI 2.5–5.9). At the examination, subjects with ECG‐LVH were older than those without it. Similar age‐ and sex‐adjusted values of HbA 1c , plasma lipids, fibrinogen, uric acid and creatinine were found in the two subgroups. No differences in prevalence of hypertension, CHD, increased QT duration or dispersion, micro‐ and macro‐albuminuria were found between subjects with ECG‐LVH and those without it. In logistic regression analysis, variables independently associated with ECG‐LVH, after age‐adjustment, were sex and diastolic blood pressure. Conclusions This population‐based study shows: (i) a high prevalence of ECG‐LVH in Type 2 diabetic subjects; (ii) 3‐fold higher risk in women than in men, independently of age, BMI, and blood pressure; (iii) an independent association between ECG‐LVH and diastolic blood‐pressure. Screening for ECG‐LVH in diabetic subjects is therefore recommended, particularly in diabetic women.