title: High risk blood pressure and obesity increase the risk for left ventricular hypertrophy in African-American adolescents.
abstract: OBJECTIVE
  To examine the relative effects of high blood pressure (HBP) and obesity on left ventricular mass (LVM) among African-American adolescents; and if metabolic or inflammatory factors contribute to LVM.
  
  
  METHODS
  Using a 2 × 2 design, African-American adolescents were stratified by body mass index percentile (body mass index <95th percentile = non-obese; ≥ 95th percentile = obese) and average blood pressure (BP) (normal BP <120/80 mm Hg; HBP ≥ 120/80). Glucose, insulin, insulin resistance, lipids, and inflammatory cytokines were measured. From echocardiography measures of LVM, calculated LVM index (LVMI) ≥ 95th percentile defined left ventricular hypertrophy (LVH).
  
  
  RESULTS
  Data included 301 adolescents (48% female), mean age 16.2 years, 51% obese, and 29% HBP. LVMI was highest among adolescents with both obesity and HBP. The multiplicative interaction of obesity and HBP on LVH was not significant (OR = 2.35, P = .20) but the independent additive associations of obesity and HBP with log-odds of LVH were significant; obesity OR = 3.26, P < .001; HBP OR = 2.92, P < .001. Metabolic and inflammatory risk factors were associated with obesity, but had no independent association with LVMI. Compared with those with average systolic BP (SBP) <75th percentile, adolescents with SBP from the 75th percentile to 90th percentile had higher LVMI (33.2 vs 38.7 g/m(2.7), P < .001) and greater LVH (18% vs 43%, P < .001), independent of obesity.
  
  
  CONCLUSIONS
  Prevalence of LVH is highest among African-American adolescents with average BP ≥ 120/80 mm Hg and obesity. There also is an independent association of LVMI with BP, beginning at the 75th SBP percentile.
authors: Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. Bonita.Falkner@jefferson.edu
authors: Bonita
authors: B
authors: Falkner
authors: Stephanie
authors: S
authors: DeLoach
authors: Scott W
authors: SW
authors: Keith
authors: Samuel S
authors: SS
authors: Gidding
mesh_terms: D000293:Adolescent; D001741:Black or African American; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D009765:Obesity / Q000150:complications*; D012307:Risk Factors