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Racial differences in cardiac structure and function in essential hypertension

^a Department of Cardiology, St Mary's Hospital Medical School, London W2 1NY Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6EA The Peart-Rose Clinic, St Mary's Hospital Medical School, Imperial College of Science, Technology and Medicine, London W2 1NY Correspondence to: Dr

Abstract

Objective : To assess racial differences in cardiac structure and function in patients presenting with previously untreated hypertension. Design - Untreated black patients with hypertension were compared with untreated white patients matched for age and sex. Both groups had similar body mass indices, blood pressures, and reported duration of hypertension.
Setting : Cardiovascular risk factor clinic for outpatients.
Subjects : 36 men and 22 women with untreated essential hypertension.
Main outcome measures : Variables of heart structure and function on cross sectional and Doppler echocardiography.
Results : The black patients had a significantly greater interventricular septal thickness (mean 1.23 (95% confidence interval 1.14 to 1.33) v 1.09 (1.02 to 1.16) cm; P=0.02) and posterior wall thickness (mean 1.14 (1.07 to 1.22) v 0.96 (0.88 to 1.03) cm; P=0.001) than the white patients although left ventricular internal diameter was not significantly different (mean 4.90 (4.68 to 5.12) v 4.82 (4.64 to 5.01) cm; P=0.59). This resulted in a significantly greater left ventricular mass index (mean 151 (137 to 164) v 120 (107 to 133) g/m²; P=0.001) and relative wall thickness (mean 0.47 (0.43 to 0.51) v 0.40 (0.37 to 0.42) cm; P=0.004) in the black patients. Comparison of Doppler measures of left ventricular diastolic function showed a significantly longer isovolumic relaxation time in black patients (mean 107 (98 to 116) v 92 (83 to 101) ms; P=0.02) compared with white patients, although peak early to atrial filling ratios were similar in both groups (mean 1.14 (0.95 to 1.32) v 1.04 (0.94 to 1.15); P=0.37).
Conclusion : Among previously untreated hypertensive patients, black subjects compared with white subjects have significantly higher left ventricular mass index and relative wall thickness, as well as more impairment of left ventricular function during diastole.

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Racial differences and hypertension

N Chauturvedi, M G Marmot, and P M McKeigue
BMJ 1994 308: 1634-1635. [Extract] [Full Text]

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