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[Left ventricular hypertrophy in patients with hypertension. A comparative study between black Africans and white
1Hôpital Max Fourestier, Nanterre.
Insights
Hypertensive Black Africans exhibited more severe hypertension and concentric left ventricular hypertrophy compared to White Europeans. Socio-economic factors likely influenced these disparities in cardiovascular health.
Area of Science:
- Cardiology
- Hypertension Research
- Comparative Medicine
Background:
- Hypertension (HT) affects diverse populations with varying clinical presentations.
- Left ventricular (LV) geometry modifications are crucial indicators of cardiovascular health in hypertensive patients.
- Understanding ethnic differences in LV geometry is vital for targeted treatment strategies.
Purpose of the Study:
- To compare clinical and ultrasonographic findings between hypertensive Black Africans and age-matched White Europeans.
- To investigate modifications in left ventricular (LV) geometry in these distinct populations.
- To identify potential disparities in hypertension severity and cardiac adaptations.
Main Methods:
- Echocardiography was used to assess LV geometry, including LV mass index (LVMI) and thickness/radius ratio (t/r).
- Clinical parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) were measured.
- 20 recently emigrated Black African men were compared with 20 age-matched White European men.
Main Results:
- Hypertensive Black Africans presented with significantly higher SBP (p < 0.01) and DBP (p < 0.01) than White Europeans.
- LVMI (p = 0.001) and the t/r ratio (p < 0.001) were significantly greater in Black Africans, indicating concentric hypertrophy.
- End-diastolic posterior wall thickness (Epp) was also significantly higher in Black Africans (p < 0.001).
Conclusions:
- Recently emigrated hypertensive Black Africans showed greater hypertension severity and concentric left ventricular hypertrophy compared to age-matched European counterparts.
- Significant differences in socio-economic status and access to healthcare may contribute to these observed disparities.
- These findings highlight the need for culturally sensitive approaches in managing hypertension and its cardiac consequences.
Objective:
The objective of this study was to compare clinical and ultrasonographic findings in 20 consecutive hypertensive Black Africans, with those of 20 hypertensive White Europeans matched for age in order to study modifications of left ventricular (VG) geometry.
Method:
20 consecutive Black men (B), recently emigrated from Africa and applying for asylum, referred for HT, were assessed by measuring systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP), body mass index (BMI), echocardiography with measurement of the end-diastolic thickness of the septum, posterior wall (Epp), LV diameter (DTD), calculation of the LV mass index (LVMI) according to the Penn convention and the thickness/radius ratio (t/r). These subjects were matched for age with 20 consecutive European White men (W) sent to the echocardiography laboratory for assessment of HT, in whom the same parameters were measured.
Results:
The mean age was 41.6 +/- 9.2 (B) vs 42.1 +/- 8.8 years (W) (NS). The BMI was 26.3 +/- 3.2 (B) vs 27.3 +/- 3.4 (W) (NS). SBP was 175 +/- 24 (B) vs 156 +/- 15 mmHg (W) (p < 0.01). DBP was 108 +/- 13 (B) vs 94 +/- 9 mmHg (W) (p < 0.01). PP was 67 +/- 20 (B) vs 63 +/- 10 mmHg (W) (NS). LVMI was 131 +/- 43 (B) vs 91 +/- 19 g/m2 (W) (p = 0.001). The t/r ratio was 0.48 +/- 0.08 (B) vs 0.38 +/- 0.07 (W) (p < 0.001). DTD was 47.1 +/- 3.9 (B) vs 48.6 +/- 4.4 mm (W) (NS). Epp was 11.2 +/- 1.9 (B) vs 9.1 +/- 1.4 mm (W) (p < 0.001). A poor correlation was observed between SBP and LVMI (r = 0.23, p = 0.17), and between SBP and t/r (r = 0.21, p = 0.21).
Conclusion:
Compared to a age-matched population of European hypertensive patients with similar morphology, our homogeneous group of recently emigrated patients was characterized by a greater severity of HT and the presence of concentric left ventricular hypertrophy. The marked difference in socio-economic status and access to care of these two populations must be stressed.