Blood pressure variables and prevalent electrocardiographic left ventricular hypertrophy in sub-Saharan African individuals with type 2 diabetes.
BACKGROUND
The aim of the present study was to investigate whether brachial blood pressure (BP) variables (systolic BP [SBP], diastolic BP [DBP], pulse [PP] and mean arterial pressure [MAP]) are similar determinants of prevalent electrocardiographic left ventricular hypertrophy (LVH) in sub-Saharan Africans with type 2 diabetes (T2D).


METHODS
The study included 420 individuals (49% men) with T2D who were receiving chronic care in two main referral centers in the two major cities (Douala and Yaounde) of Cameroon. Logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for a standard deviation (SD) higher level of SBP (25 mmHg), DBP (13), PP (18) and MAP (20) with the risk of LVH. Discrimination was assessed and compared with c-statistics and relative integrated discrimination improvement (RIDI; %).


RESULTS
The multivariable adjusted OR (95% CI) for prevalent LVH with each SD higher pressure variable was 1.61 (1.22-2.11) for SBP, 1.27 (0.99-1.63) for DBP, 1.62 (1.23-2.15) for PP and 1.44 (1.11-1.87) for MAP. Comparison of c-statistics revealed no difference in the discrimination power of models with each of the BP variables (P > 0.09). However, RIDI showed enhanced discrimination in the models when other BP variables were replaced with PP. However, this enhancement was marginal for SBP. Using BP combinations modestly improved discrimination.


CONCLUSIONS
The best predictors of prevalent LVH in the present study population were PP and SBP, whereas DBP was the least effective predictor. These findings have implications for cardiovascular risk stratification and monitoring of risk-reducing therapies.
Department of Medicine, Douala General Hospital and Buea University, Douala, South Africa.
Anastase
A
Dzudie
Simeon P
SP
Choukem
Mesmin Y
MY
Dehayem
Andre P
AP
Kengne
D017954:Africa South of the Sahara; D062186:Arterial Pressure; D001795:Blood Pressure Determination; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence