Echocardiographic Assessment of Hypertensive Left Ventricular Hypertrophy in Patients with Acute Ischemic Stroke or Transient Ischemic Attack

Background: Hypertensive left ventricular hypertrophy (HLVH) is a major risk factor for cardiovascular morbidity, mortality, and stroke. However, little is known about the importance of transthoracic echocardiography (TTE) in the assessment of HLVH in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). Methods: We studied 203 consecutive patients admitted to our hospital with AIS or TIA and who were referred for TTE over the last 4 years. We included 102 (50.2%) lacunar strokes, 76 (37.1%) nonlacunar strokes, and 25 (12.3%) TIAs. The mean age was 68.9 years (standard deviation +/- 11) and 128 patients were male (63.1%). Results: Hypertension was the most common risk factor (131 patients; 64.5%). HLVHwas seen in 86 cases (42.3%), in 51.9% of patients with previous hypertension, and in 25% of patients without known hypertension. We found that neither stroke subtype nor any previous risk factor, with the exception of hypertension (P=.0001), were associated with HLVH. Patients with HLVH were younger (67 v 71 yrs; P=.013) and more frequently women(50.6% v 37.5%; P=.078). At discharge, patients with HLVH were more likely to receive antihypertensive treatment (97% v 80%; P=.009) and a higher average number of antihypertensive drugs (2.2 v 1.4; P=.0001). Conclusions: HLVH was common in patients with AIS or TIA. These individuals had an increased risk of stroke and needed a more intensive therapy. TTE should be carried out in all AIS and TIA patients in order to optimize the management of these patients.