Racial differences in cardiac structure and function in essential hypertension.
OBJECTIVE
To assess racial differences in cardiac structure and function in patients presenting with previously untreated hypertension.


METHODS
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.


METHODS
Cardiovascular risk factor clinic for outpatients.


METHODS
36 men and 22 women with untreated essential hypertension.


METHODS
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).


CONCLUSIONS
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.
Mayet
J
J
Department of Cardiology, St Mary's Hospital Medical School, London.
Shahi
M
M
Foale
R A
RA
Poulter
N R
NR
Sever
P S
PS
McG Thom
S A
SA
D000328:Adult; D044383:Black People; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006339:Heart Rate; D006346:Heart Septum / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left; D044465:White People