Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies

Left-ventricular hypertrophy (LVH) is a cardinal manifestation of hypertensive organ damage associated with an increased cardiovascular (CV) risk. We reviewed recent literature on the prevalence of LVH, as assessed by echocardiography, in order to offer an updated information on the magnitude of subclinical alterations in LV structure in contemporary human hypertension. A MEDLINE search using key words ‘left ventricular hypertrophy’, ‘hypertension’, ‘echocardiography’ and ‘cardiac organ damage’ was performed in order to identify relevant papers. Full articles published in English language in the last decade, (1 January 2000–1 December 2010), reporting studies in adult or elderly individuals, were considered. A total of 30 studies, including 37 700 untreated and treated patients (80.3% Caucasian, 52.4% men, 9.6% diabetics, 2.6% with CV disease) were considered. LVH was defined by 23 criteria; its prevalence ranged from 36% (conservative criteria) to 41% (less conservative criteria) in the pooled population. LVH prevalence was not different between women and men (range 37.9–46.2 versus 36.0–43.5%, respectively). Eccentric LVH was more frequent than concentric hypertrophy (range 20.3–23.0 versus 14.8–15.8, respectively, P