Clinical correlates of left ventricular hypertrophy in black patients with arterial hypertension.
OBJECTIVE
To assess the relationship between the lipid profile, other cardiovascular risk factors and left ventricular hypertrophy (LVH) in black hypertensive patients.


METHODS
We undertook a cross-sectional study of a case series at the hypertension clinic, University of Kinshasa Hospital. Lipids, lipoproteins and other cardiovascular risk factors were analysed in 100 consecutive hypertensive patients. Left ventricular hypertrophy was assessed by 12-lead electrocardiography (ECG) using Cornell voltage index.


RESULTS
Forty-eight hypertensive patients, 26 men and 22 women, had LVH. With univariate analysis, the patients with LVH were older (age 52 +/- 9 vs 45 +/- 9 years; p </= 0.001), had higher pulse pressure levels (57 +/- 11 vs 50 +/- 15 mm Hg; p </= 0,01), and more were receiving antihypertensive treatment (68 vs 28%; </= 0.001) compared to those without LVH. With multiple logistic regression analysis, the duration of hypertension, high high-density lipoprotein cholesterol (HDL-C) and plasma glucose levels, and being on antihypertensive treatment have emerged as the main predictors of the presence of LVH. The patients with duration of hypertension two years or more (adjusted OR 7.23; 95% CI: 1.576-42.884) had a higher risk for LVH; however, those with HDL-C >/= 1.03 mmol/l (adjusted OR 0.19; 95% CI: 0.057-0.651), plasma glucose >/= 6.11 mmol/l (adjusted OR 0.19; 95% CI: 0.046- 0.828), or on treatment for hypertension (adjusted OR 0.23; 95% CI: 0.082-0.645) had a lower risk for cardiac damage compared to their respective control groups.


CONCLUSIONS
LVH is a common complication in Congolese hypertensives. Dyslipidaemia, high plasma glucose levels, the duration of hypertension and being on antihypertensive therapy appear to be the main predictors of hypertensive cardiac damage.
Department of Medical Physiology, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa.
F B
FB
Lepira
P K
PK
Kayembe
J R
JR
M'buyamba-Kabangu
M N
MN
Nseka
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D015023:Democratic Republic of the Congo / Q000208:ethnology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000208:ethnology* / Q000209:etiology* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
D000959:Antihypertensive Agents; D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids