Introduction: Regardless of other known factors, left ventricular hypertrophy is considered to be a significant factor which correlates with the risk of cardiovascular complications. In practice, it is very important to predict the outcome for every patient at the beginning of the treatment.
Objective: The aim of the study was to follow the predictive value of non-invasive parameters obtained at the beginning of the study in patients with essential arterial hypertension and left ventricular hypertrophy who were treated by regular therapy through a five year follow-up period.
Methods: Ninety patients (average age 55) with essential hypertension and left ventricular hypertrophy were examined. All patients were studied at baseline after temporary discontinuation of previous antihypertensive therapy. The follow-up period started at the baseline examination and lasted for five years. Adverse cardiovascular events occurred in 15 (16.7%) patients.
Results: Non-invasive parameters were tested by stepwise multiple regression analysis. Three examined parameters had predictive value: QTc interval dispersion (beta = 0.325, p = 0.001), septal wall thickness (beta = 0.294, p = 0.003) and low increase of the heart rate during exercise testing (beta = -0.202, p < 0.04). For this model, adjusted R square = 0.203; F3,84 = 8.406, p < 0.0001.
Conclusion: In spite of regular medical treatment, patients with larger QTc dispersion, greater septum thickness and lower increase of heart rate during exercise testing showed worse outcome through the follow-up period. These patients should be recognized as early as possible and treated more aggressively.