Association of Electrocardiographic Left Ventricular Hypertrophy with Future Renal Function Decline in the General Population

Background: Electrocardiographic left ventricular hypertrophy (LVH) could predict adverse renal outcome in patients with hypertension. This study aimed to investigate the association between electrocardiographic LVH and future decline of renal function in the general population. Methods: This retrospective cohort study included individuals who received population-based health checkups from 2010 to 2019 in Japan. Electrocardiographic LVH was defined according to the Minnesota code. Renal function decline was defined as a decrease of 25% in the estimated glomerular filtration rate from baseline to <60 mL/min/1.73 m2. Multivariate adjusted Cox regression analysis was employed to evaluate the association between electrocardiographic LVH at baseline and renal function decline. Results: Of the 19,825 study participants, 1,263 exhibited electrocardiographic LVH at the baseline visit. The mean follow-up period was 3.4 ± 1.9 years. The incidence rates of renal function decline were 0.30 and 0.78 per 100 person-years in the non-LVH group and LVH groups, respectively. Electrocardiographic LVH was associated with the risk for renal function decline in both unadjusted analysis (hazard ratio 2.50, 95% confidence interval 1.73-3.60, P < 0.001) and adjusted analysis (hazard ratio 1.69, 95% confidence interval 1.14-2.50, P = 0.009). This association was comparable across subgroups stratified by age, sex, body mass index, diagnosed hypertension, systolic blood pressure, hemoglobin A1c, and urinary protein. Conclusions: In the general population, electrocardiographic LVH was associated with future renal function decline. To detect high-risk individuals for renal function decline, electrocardiographic LVH may be useful in the setting of health checkups in the general population. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement None. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the local ethics committee at the Kyushu University Hospital (Approval no. 22181-00) and Ehime University (Approval no. 1912011). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study were available from JA Ehime Kouseiren Checkup Center. This corresponding author is not in a position to decide the data sharing.