Comparison of Demographic Factors and Personal Lifestyle Characteristics with 2020 ISH Guidelines for High Normal Blood Pressure in Relation to Absence and Presence of ECG Diagnosed LVH in Healthy Adults: A Cross-sectional Study

Introduction: Early identification of Left Ventricular Hypertrophy (LVH), a powerful and independent predictor of Cardiovascular Disease (CVD), is a key element for preventing Cardiovascular Events (CVE). High-Normal Blood Pressure (HNBP) was significantly associated with a new-onset Electrocardiogram (ECG) diagnosed LVH. The demographic and personal lifestyle characteristics could be related to HNBP in ECG diagnosed LVH. This relation, if found, can be useful as a factor for early identification of HNBP in relation to ECG diagnosed LVH.

Aim: To compare demographic and personal lifestyle characteristics with HNBP in relation to ECG diagnosed LVH in healthy adults.

Materials and Methods: The cross-sectional study was conducted in AIIMS Raipur (CG) from April 2021 to March 2022 among 95 healthy adult males between 20 to 39 years with a Blood Pressure (BP) of 130-139/85-89 mm Hg and no anti-hypertensive medications. Permission was obtained from the Ethics committee of AIIMS Raipur (CG). Data was collected from the individuals using health questionnaire, Personal Lifestyle Questionnaire (PLQ), validated anthropometric equipment stature meter for measuring height and weighing machine, a working electronic BP measuring instrument, and ECG. The present study included demographic factors like age, height, weight, Body Mass Index (BMI), educational level, marital status, occupation, and Socio-Economic Status (SES) classified based on Kuppuswamy’s classification. The personal lifestyle characteristics included physical activity, use of substances (alcohol, smoking, tobacco, gutkha), and diet. The unpaired t-test, Chi-square test and regression analysis were applied for the analysis of the collected data.

Results: Representation of demographic factors were age (31.9±5.08), height (1.69±0.06), weight (68.3±10.2), BMI (23.8±3.05) in terms of (mean±SD) and SES in terms of n (%) were upper I-7 (7.4), upper middle II-31 (32.6), lower middle III-30 (31.6), upper lower IV-25 (26.3), lower V-2 (2.1). SES classes of modified Kuppuswamy’s SES scale had a significant relationship with LVH {p-value <0.05 (0.003)}. All LVH (+) individuals were from the lower middle III SES class {7 (7.4%)}. Daily use of substances (alcohol, smoking, tobacco, gutkha) had a significant association with LVH {p-value <0.05 (0.005)}. Group-IV (35-39 years) (standard coefficient 0.4621059, 95%CI-0.0385065 to 0.4686115; p-value-0.021) had more positive relation than Group-II (25-29 years) (std. coef. 0.4422758, 95%CI-0.0501719 to 0.4566986; p-value-0.015). Primary Educational level (std. coef.-0.2473403, 95%CI-0.8019454 to-0.0982954; p-value-0.013) had a negative relation with SL-LVH (p<0.05).

Conclusion: The study concluded that lower middle III class SES and daily use of substances (alcohol, smoking, tobacco, gutkha), age Group-IV (35-39 years), and primary educational level were the predicted demographic and lifestyle characteristics of HNBP in relation to ECG diagnosed LVH.