Gender differences in the diagnosis and treatment of left ventricular hypertrophy detected by different electrocardiographic criteria. Findings from the SARA study.

This study examines the influence of gender on the detection of left ventricular hypertrophy (LVH) by different electrocardiographic (ECG) criteria and the potential changes induced by antihypertensive therapy from the SARA study ("eStudio del trAtamiento con candesaRtan en pacientes con hipertensión Arterial según criterios electrocardiográficos") database. The SARA study was aimed to determine the effect of a 12-month candesartan-based regimen on ECG-LVH. Overall, 264 patients were included. Cornell voltage index (CorV), Cornell product (CorP), Sokolow-Lyon voltage index (SokV), and Sokolow-Lyon product (SokP) were calculated. At baseline, 39.3% of women and 15.4% of men exhibited ECG-LVH by CorP criteria, and 18.2% of women and 30.6% of men had LVH by SokP. When voltage criteria were applied, LVH was detected in 20.5% of women and 5.9% of men by CorV, and in 10.7% and 13.4%, respectively, by SokV. At the end of the study, the proportion of patients with ECG-LVH by CorP was 28.7% in women (P < 0.001) and 14.4% in men (P = not significant [n.s.]), and in 21.2% (P = n.s.) and 22.1% (P = 0.01) by SokP. Left ventricular hypertrophy by CorV were present in 17.9% of women and 9.0% of men (both P = 0.001), and in 10.6% and 13.3%, respectively by SokV (both P = n.s.). In ECG-LVH hypertensive patients, candesartan was an efficacious drug to regress LVH in the clinical practice setting. The voltage-duration product criteria suggestively detected ECG-LVH and its respective changes better than voltage criteria. Although in daily clinical practice the use of both product criteria seemed clearly preferable to voltage for assessment of ECG-LVH, the CorP appeared to be markedly more useful in women and SokP in men.