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Mid-life risk factors predict cardiac remodeling in old age

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Excessive weight, smoking, diabetes, and hypertension in mid-life are strongly correlated with the development of left ventricular (LV) hypertrophy, investigators report in an early online release from the journal Circulation.

Using data from the Framingham Offspring Study, Dr. Ramachandran S. Vasan, at the Boston University School of Medicine, and his associates prospectively tracked “the evolution of subclinical LV remodeling and stage B heart failure in the community, which antedate overt heart disease by years to decades.”

Included were 4217 subjects (mean age 45 years, 53% female) from whom up to 4 echocardiograms were obtained between 1979 and 1998. The researchers conducted a separate analysis of 2605 individuals who underwent echocardiography two times, 4 years apart.

“Overall,” Dr. Vasan’s team writes, “we observed a remarkable consistency in the correlates of LV mass in analyses conducted using multiple observations over a 16-year period versus evaluation of a 4-year change in LV mass.”

Antihypertensive treatment, body mass index, systolic blood pressure, smoking, and diabetes were associated with LV mass over the adult life course. Age and gender were also associated with LV thickening. Compared with men, women had a greater and steeper increase in LV mass with increasing age and with higher BMI, the authors note.

Moreover, subjects with more risk factors had higher LV mass at baseline and exhibited a steeper increase over time.

“These factors can be directly targeted for prevention and lowering these risk factors, therefore, could potentially lower the burden of heart failure,” Dr. Vasan noted in a prepared statement.

“People with fewer risk factors had almost no increase in LV mass with age, Dr. Vasan added.

Circulation 2009.