Left Ventricular Hypertrophy (LVH) and stroke


Left ventricular hypertrophy (LVH) is the enlargement and thickening of the walls of your heart’s left ventricle. The left ventricle is the main pumping chamber of your heart. LVH is confirmed by an abnormal electrical or anatomical finding using either an echocardiogram (ultrasound) or cardiac imaging.


LVH is a significant risk factor for future cardiovascular events such as heart attack, heart failure, and stroke. Having LVH means you have a 3 to 15 times great risk cardiovascular events. LVH most significantly increases your risk of ischemic stroke and heart failure.[1]   


The most important things you can do to reduce your risk of LVH are to manage your blood pressure and stop smoking.[2] You’re also at a higher risk for LVH if you are over 50 and female. Other significant risk factors for LVH include a high BMI, glucose intolerance, cardiac valve disease and chronic heart disease.


The good news is that reducing your risk of LVH also appears to significantly reduce overall deaths from cardiovascular disease.[3] LVH seems to have decreased over the past 4 decades, probably as a result of improved control of high blood pressure across the population. Although most studies of LVH and stroke risk is have been done on Caucasians, it appears that blacks and Asians respond in similar ways. Other independent predictors for LVH include age greater than 50 years, female gender, and systolic blood pressure >=140.  Other significant risk factors for LVH include obesity, stature, glucose intolerance, cardiac valve disease and chronic heart disease.


[1] Kannel WB, Left ventricular hypertrophy as a risk factor:  The Framingham experience. J. Hypertension Supple 1991;9(2):S3-S8.

[2] Bots ML, Nikitin Y, Salonen JT, et.al. Left ventricular hypertrophy and risk of fatal and non-fatal stroke.  EUROSTROKE:  a collaborative study among research centers in Europe, J Epidemiol Community Health 2002;56(Suppl 1): i8-i13.

[3] Levy D, Salomon M, D’Agostino RB et al. Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy.  Circulation 1994; 90:1786-93.