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Comparison of left ventricular mass and geometry in black and white patients with essential hypertension
M J Koren1, G A Mensah, J Blake
1Department of Medicine, New York Hospital-Cornell Medical Center, NY 10021.
Insights
Black patients with essential hypertension showed greater left ventricular (LV) mass and relative wall thickness compared to white patients. Race was a significant predictor of abnormal cardiac geometry in hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Racial Health Disparities
Background:
- Essential hypertension is a common condition affecting cardiovascular health.
- Racial differences in cardiovascular responses to hypertension are not fully understood.
- Left ventricular (LV) remodeling is a key indicator of cardiac adaptation to pressure overload.
Purpose of the Study:
- To investigate racial disparities in cardiac structure and geometry in patients with essential hypertension.
- To compare echocardiographic measurements of LV mass and relative wall thickness between black and white hypertensive patients.
Main Methods:
- Echocardiographic assessment of LV mass and relative wall thickness.
- Comparison of cardiac parameters between 380 white and 47 black patients with uncomplicated essential hypertension.
- Multivariate analysis to identify predictors of increased LV mass and abnormal cardiac geometry.
Main Results:
- Black patients exhibited significantly greater LV mass indexed for body surface area and relative wall thickness compared to white patients.
- The prevalence of LV hypertrophy was twice as high in black patients (41%) versus white patients (19%).
- Systolic blood pressure, age, and race were consistent predictors of increased LV mass and abnormal cardiac geometry.
Conclusions:
- Black individuals with essential hypertension demonstrate a higher prevalence of adverse cardiac remodeling, including increased LV mass and hypertrophy.
- Race is an independent predictor of altered cardiac geometry in the context of elevated blood pressure.
- These findings highlight potential racial disparities in cardiovascular adaptation to hypertension that warrant further investigation.
Abstract:
To assess racial difference in cardiac responses to elevated blood pressure, we compared echocardiographic measurements of left ventricular (LV) mass and the wall thickness to chamber dimension ratio (relative wall thickness) in 380 white and 47 black patients with uncomplicated essential hypertension consecutively enrolled in echocardiographic research studies at The New York Hospital Hypertension Center. Diastolic blood pressure and weight were slightly greater in black as compared with white subjects (104 +/- 18 v 98 +/- 11 mm Hg; P = .014 and 82 +/- 17 v 77 +/- 15 kg; P = .037, respectively), however the groups were similar with respect to age, duration of hypertension, cholesterol level, cigarette smoking, past use of antihypertensive therapy, family history of heart disease, and height. On average, LV mass indexed for body surface area and relative wall thickness were significantly greater in blacks than whites (119 v 105 g/m2; P = .02 and 0.46 v 0.39; P = .003) and blacks had twice the prevalence of LV hypertrophy (41% v 19%; P < .001) or concentric remodeling (21% v 12%; P < .05). The magnitude of increased LV mass and relative wall thickness in blacks was similar in men (132 v 110 g/m2; P = .01 and 0.44 v 0.39; P = .04) and in women (107 v 94 g/m2; P = .11 and 0.48 v 0.39; P = .02). In multivariate analyses, systolic blood pressure, age, and race were consistently predictors of increased LV mass and abnormal cardiac geometry. Cholesterol level was not independently associated with increased LV mass but was weakly associated with increased relative wall thickness.(ABSTRACT TRUNCATED AT 250 WORDS)