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Correlates of left ventricular mass in hypertensive Nigerians: an echocardiographic study
1Department of Medicine, Federal Medical Centre, Idi-Aba, Abeokuta, Nigeria. osogah56156@yahoo.com
Insights
In hypertensive Nigerians, left ventricular mass is influenced by factors beyond blood pressure, including wall tension, stress, atrial size, alcohol, and family history. Understanding these correlates aids in managing left ventricular hypertrophy.
Area of Science:
- Cardiology
- Hypertension Research
- Medical Imaging
Background:
- Left ventricular mass (LVM) assessed by echocardiography shows poor correlation with blood pressure.
- Other factors like age, gender, and genetics influence LVM, necessitating further study in diverse populations.
- Limited research exists on LVM determinants in native African populations.
Purpose of the Study:
- To identify the independent correlates of left ventricular mass in hypertensive Nigerians.
- To provide insights for developing targeted prevention and management strategies for left ventricular hypertrophy.
Main Methods:
- Retrospective analysis of prospectively collected data from 285 hypertensive Nigerian subjects.
- Echocardiographic measurement of left ventricular mass using standard formulas.
- Stepwise multiple regression analysis to determine independent predictors of LVM.
Main Results:
- Key predictors of LVM included left ventricular wall tension, left ventricular wall stress, left atrial size, diastolic blood pressure, alcohol consumption, and family history of hypertension.
- The identified factors explained approximately 95% of the variability in left ventricular mass.
- No significant gender differences were observed in most echocardiographic parameters.
Conclusions:
- Left ventricular mass in hypertensive Nigerians is determined by a combination of mechanical, hemodynamic, genetic, and social factors.
- Modulating these identified factors through pharmacological or non-pharmacological interventions may benefit patient management.
- Further research is warranted to explore the interplay of these factors in left ventricular hypertrophy.
Background:
Studies have shown that left ventricular mass, diagnosed by echocardiography, correlated poorly with blood pressure, even when the 24-hour ambulatory blood pressure monitoring was taken into account in the analysis. This may be partly because there are other determinants of left ventricular mass such as age, gender, neurohormonal factors and heredity. Knowledge of the correlates of left ventricular mass could help design individual and population strategies to prevent or reverse left ventricular hypertrophy. To the best of our knowledge, there is a paucity of such studies in native Africans. Hence the purpose of this study was to define the correlates of left ventricular mass in hypertensive Nigerians.
Methods:
The study was a retrospective analysis of prospectively collected data in 285 hypertensive subjects. Echocardiographic left ventricular mass was determined using the standard formula. Stepwise multiple regression analysis was used to determine the independent predictors of left ventricular mass with a probability value to enter and remove of p < 0.05.
Results:
There were 153 men (53.7%) and 132 women (46.3%) in the study. The mean age of all subjects was 58.2 +/- 13.7 years. There was no significant gender difference in most of the echocardiographic parameters. In a stepwise multiple regression analysis, left ventricular wall tension, left ventricular wall stress, left atrial size, diastolic blood pressure, alcohol consumption and a family history of hypertension were the independent predictors of left ventricular mass in this population. The optimum multivariate linear regression main effects had an adjusted model, r(2) of 0.945, thus explaining about 95% of left ventricular mass variability.
Conclusion:
Mechanical or haemodynamic factors possibly interacting with genetic and social factors are the likely determinants of left ventricular mass in hypertensive Nigerians. Therefore modulation of some of these factors pharmacologically or non-pharmacologically will be of benefit in the management of this patient population.
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