Left ventricular mass and cardiovascular morbidity in essential hypertension: The MAVI study

OBjectives This study investigated the prognostic value of left ventricular (LV) mass at echo cardiography in uncomplicated subjects with essential hypertension. Background Only a few single-center studies support the prognostic value of LV mass in uncomplicated hypertension. Methods The MAssa Ventricolare sinistra nell'Ipertensione study was a multicenter (45 centers) prospective study. The prespecified aim was to explore the prognostic value of LV mass in hypertension Admission criteria included essential hypertension, no previous cardiovascular events, and age greater than or equal to 50. There was central reading of echo cardiographic tracings. Treatment was tailored to the single subject. Results Overall, 1,033 subjects (396 men) were followed for 0 to 4 years (median, 3 years). Mean age at entry was 60 years, and systolic/diastolic blood pressure was 154/92 mm Hg. The rate of cardiovascular events (x 100 patient-years) was 1.3 in the group with normal LV mass and 3.2 in the group (28.5% of total sample) with LV mass greater than or equal to 125 g/body surface area (p=0.005). After adjustment for age (p<0.01), diabetes (p<0.01), cigarette smoking (p<0.01) and serum creatinine (p=0.03), LV hypertrophy was associated with an increased risk of events (RR [relative risk] 2.09; 95% CI [confidence interval]: 1.22 to 3.57). For each 39 g/m(2) (I SD) increase in LV mass there was an independent 40% rise in the risk of major cardiovascular events (95% CI: 14 to 72; p=0.0013). Conclusions Our findings show a strong, continuous and independent relationship of LV mass to subsequent cardiovascular morbidity. This is the first study to extend such demonstration to a large nationwide multicenter sample of uncomplicated subjects with essential hypertension. (J Am Coli Cardiol 2001;38:1829-35) (C) 2001 by the American College of Cardiology.