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Contrast in cardiac anatomy and function between black and white patients with hypertension
Insights
Cardiac differences exist between Black and White individuals with essential hypertension. Black hypertensives showed higher total peripheral resistance and lower cardiac output compared to White hypertensives.
Area of Science:
- Cardiology
- Hypertension Research
- Racial Health Disparities
Background:
- Essential hypertension affects cardiovascular structure and function.
- Understanding racial differences in hypertension pathophysiology is crucial for targeted treatment.
Purpose of the Study:
- To investigate cardiac differences between Black and White individuals with essential hypertension.
- To identify potential disparities in cardiovascular responses to similar blood pressure elevations.
Main Methods:
- M-mode echocardiography was performed on 207 employees (75 hypertensives, 132 normotensives).
- Left ventricular mass index (LVMI), relative wall thickness (RWTd), cardiac output (CO), and total peripheral resistance (TPR) were calculated.
- Comparisons were made between racial groups within hypertensive and normotensive cohorts.
Main Results:
- No significant cardiac differences were observed between Black and White normotensive individuals.
- Black hypertensives exhibited significantly higher TPR (P<.01) and RWTd (P<.05) compared to White hypertensives.
- Black hypertensives also demonstrated significantly lower CO (P<.01) than White hypertensives.
Conclusions:
- Observed cardiac differences in hypertension are not race-specific but may indicate distinct pathophysiological mechanisms.
- These findings suggest that Black and White individuals with similar blood pressure elevations may experience different cardiovascular adaptations.
- Further research is warranted to elucidate the underlying mechanisms driving these disparities in hypertension management.
Abstract:
To determine whether cardiac findings differ between blacks and whites with essential hypertension, members of a well-defined working population in New York City were examined. Hypertensives had diastolic blood pressure ≤95, or systolic blood pressure ≤160 mmHg, or both, sustained on three occasions over three weeks. Normotensives were selected to reflect the age, sex, and race distribution of the total working population. Of 207 employees, 75 hypertensives (40 percent blacks) and 132 normotensives (53 percent blacks) under-went M-mode echocardiography. Left ventricular (LV) measurements and simultaneous blood pressure by mercury manometer were used to calculate LV mass index (LVMI), relative wall thickness (RWTd), cardiac output (CO) and total peripheral resistance (TPR). There were no differences in any variable between black and white normotensives. Black and white hypertensives were similar in age (52 ± 10 and 54 ± 12 yr, respectively) and blood pressure (151/100 ± 15/11 and 153/99 ± 18/8 mmHg). Black hypertensives had significantly higher TPR (1.80 ± 0.74 vs 1.43 ± 0.46, P<.01), lower CO (6.0 ± 2.5 vs 7.2 ± 2.4 L/min, P<.01), and higher RWTd (0.43 ± 0.11 vs 0.37 ± 0.07, P<.05) than white hypertensives. Race, per se, cannot explain these differences since they did not occur among normotensives. Rather, these findings may reflect a differing patho-physiology of hypertension in blacks and whites with similar blood pressure elevation.