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Left ventricular hypertrophy is more prevalent in blacks than whites in the general population: the Dallas Heart
Mark H Drazner1, Daniel L Dries, Ronald M Peshock
1Donald W. Reynolds Cardiovascular Clinical Research Center, Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. Mark.Drazner@utsouthwestern.edu
Insights
Black individuals have a 2- to 3-fold higher prevalence of left ventricular hypertrophy compared to white individuals, independent of body composition. This finding was consistent across different measurement methods in the general population.
Area of Science:
- Cardiology
- Population Health
- Medical Imaging
Background:
- Previous studies suggested higher left ventricular hypertrophy (LVH) prevalence in Black compared to White populations.
- Uncertainty remained regarding these disparities after adjusting for body composition and using cardiac MRI.
Purpose of the Study:
- To determine if ethnic disparities in left ventricular hypertrophy (LVH) persist in the general population after adjusting for body composition.
- To assess LVH prevalence using cardiac MRI in Black and White adults.
Main Methods:
- Utilized data from the Dallas Heart Study, a population-based cohort.
- Included 1335 Black and 858 White participants aged 30-67 years.
- Assessed body composition via dual-energy x-ray absorptiometry and cardiac MRI for LVH.
Main Results:
- Left ventricular hypertrophy was 2- to 3-fold more common in Black versus White women and men.
- Ethnic disparities in left ventricular mass persisted after adjusting for fat mass, fat-free mass, blood pressure, age, gender, and socioeconomic status.
- Findings were consistent regardless of LVH indexation method (body surface area, fat-free mass, or height2.7).
Conclusions:
- Black individuals exhibit significantly higher left ventricular mass and LVH prevalence compared to White individuals.
- These ethnic differences in left ventricular mass are independent of body composition.
- Cardiac MRI confirms a 2- to 3-fold higher prevalence of LVH in Black adults within the general population.
Abstract:
Although recent studies have suggested that blacks compared with whites have an increased prevalence of left ventricular hypertrophy, it remains uncertain whether this is true despite adjustment for body composition (fat mass and fat-free mass) and when assessed by cardiac MRI in the general population. The Dallas Heart Study is a population-based study of Dallas County in which 1335 black and 858 white participants 30 to 67 years of age underwent detailed assessment including dual-energy x-ray absorptiometry scan to measure body composition and cardiac MRI. Left ventricular hypertrophy, whether defined by indexation to body surface area (P<0.001), fat-free mass (P=0.002), or height2.7 (P<0.001) was 2- to 3-fold more common in black versus white women. Similar results were seen when comparing black and white men (P<0.001 when left ventricular hypertrophy was indexed to body surface area or height2.7 and P=0.05 when indexed to fat-free mass). Ethnic disparities in left ventricular mass persisted in multivariable models despite adjustment for fat mass, fat-free mass, systolic blood pressure, age, gender, and measures of socioeconomic status. We conclude that blacks compared with whites have increased left ventricular mass and a 2- to 3-fold higher prevalence of left ventricular hypertrophy in the general population, as assessed by cardiac MRI. The ethnic differences in left ventricular mass are independent of differences in body composition.
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