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Left ventricular hypertrophy among dark- and light-skinned Puerto Rican men: the Puerto Rico Heart Health Program
P D Sorlie1, M R García-Palmieri, R Costas
1Field Studies and Biometry Branch, National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Insights
Darker-skinned Puerto Rican men showed increased prevalence of left ventricular hypertrophy (LVH) and higher mortality risk. This finding highlights potential racial disparities in cardiovascular disease risk factors.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Coronary heart disease (CHD) risk factors and outcomes can vary across racial groups.
- Understanding disparities in cardiovascular health is crucial for targeted interventions.
- The Puerto Rico Heart Health Program investigates CHD in urban Puerto Rican men.
Purpose of the Study:
- To investigate the association between skin color and left ventricular hypertrophy (LVH) in urban Puerto Rican men.
- To assess the impact of skin color on mortality risk in the context of LVH.
Main Methods:
- Assessed skin color in 3366 urban men participating in the Puerto Rico Heart Health Program.
- Conducted comprehensive cardiovascular examinations including blood pressure, weight, physical activity, smoking, and ECG for LVH.
- Followed participants for mortality over 6 years.
Main Results:
- Darker-skinned men exhibited a higher prevalence of definite and possible LVH-ECG, even after adjusting for hypertension, weight, activity, and smoking.
- Multivariate analysis revealed approximately double the prevalence of LVH-ECG in darker-skinned men.
- Definite LVH-ECG was associated with significantly increased 6-year mortality risk, particularly in darker-skinned men (sevenfold increase).
Conclusions:
- Skin color is independently associated with LVH-ECG prevalence in Puerto Rican men.
- Darker skin pigmentation may be a marker for increased cardiovascular risk, including LVH and mortality.
- Further research is needed to elucidate the biological and social mechanisms underlying these observed disparities.
Abstract:
Racial groups were assessed by determinations of skin color in 3366 urban men in the Puerto Rico Heart Health Program, an epidemiologic study of coronary heart disease in Puerto Rico. These men participated in a comprehensive cardiovascular examination that included assessment of blood pressure, relative weight, physical activity, cigarette smoking, left ventricular hypertrophy (LVH) as determined by ECG, and measurements of skinfold thickness. They were followed for mortality over the next 6 years. Dark-skinned Puerto Rican men had a higher prevalence of both definite and possible LVH-ECG after stratifying by levels of hypertension, relative weight, physical activity, number of cigarettes smoked, and subscapular skinfold thickness. After multivariate adjustment of these factors, the dark-skinned men had approximately twice the prevalence of both definite and possible LVH-ECG as the lighter skinned men. Definite LVH-ECG carries a high mortality risk over the next 6 years as compared to men without definite LVH (fivefold increased risk in lighter skinned and sevenfold increased risk in darker skinned Puerto Rican men).