(Hypertension. 2001;38:417.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Left Ventricular Systolic Dysfunction in a Biracial Sample of Hypertensive Adults
The HyperGEN Study
Weill Medical College of Cornell University (R.B.D., J.N.B., V.P., M.P., D.F.), New York, NY; University of Alabama (A.O.), Birmingham; Wake Forest University School of Medicine (D.W.K.), Winston-Salem, NC; University of Utah School of Medicine (P.N.H.), Salt Lake City; Washington University (D.C.R., D.M.), St Louis, Mo; and University of Minnesota (D.K.A.), Minneapolis.
Correspondence to Richard B. Devereux, MD, Division of Cardiology, New York Presbyterian Hospital, 525 E 68th St, New York, NY 10021. E-mail rbdevere{at}med.cornell.edu
Abstract—— To determine the prevalence and correlates of left ventricular systolic dysfunction in hypertensive patients in a biracial population-based sample, clinical evaluation and echocardiography were performed in 2086 participants in the Hypertension Genetic Epidemiology Network (HyperGEN) examination; 86% had normal ejection fraction (>54%), 10% had mild ventricular dysfunction (ejection fraction 41% to 54%), and 4% had severe ventricular dysfunction (ejection fraction 
40%). Prevalences of mild and severe ventricular dysfunction were higher in men than women (14% versus 8% and 7% versus 3%, P<0.001) and, weakly, in diabetics than nondiabetics (13% versus 10% and 6% versus 4%, P=0.07). Patients with severe ventricular dysfunction were older than those with mild dysfunction or normal function (mean, 58 versus 54 and 54 years, respectively; P=0.005) and had higher mean creatinine (1.20 versus 1.05 and 1.00 mg/dL) and uric acid (6.9 versus 6.3 and 6.1 mg/dL) levels (both P<0.001). Those with severe ventricular dysfunction, compared with those with mild dysfunction or normal ejection fraction, had greater mean ventricular internal dimension (6.2 versus 5.6 and 5.1 cm) and mass (61 versus 50 and 43 g/m2.7) and lower relative wall thickness (0.31 versus 33 and 0.35; all P<0.0001). Severe and mild ventricular dysfunction was associated with lower myocardial contractility (mean stress-corrected midwall shortening, 68% versus 94% versus 106% of predicted; P<0.0001). In regression analyses, lower ejection fraction as a continuous variable was independently and positively associated with male gender, diabetes, uric acid level, and body mass index. With the addition of echocardiographic variables, lower ejection fraction was associated with male gender, black race, prior myocardial infarction, and higher ventricular mass and lower relative wall thickness, pulse pressure, and body mass index. In a population-based sample of hypertensive patients, left ventricular systolic dysfunction was related to male gender, black race, diabetes, and elevated uric acid levels, as well as higher ventricular mass and lower relative wall thickness.
Key Words: diabetes • diastole • echocardiography • hypertension • ventricular dysfunction
This article has been cited by other articles:
 |
|
 |
|
  P. M. Okin, E. Gerdts, S. E. Kjeldsen, S. Julius, J. M. Edelman, B. Dahlof, R. B. Devereux, and for the Losartan Intervention for Endpoint Reducti Gender Differences in Regression of Electrocardiographic Left Ventricular Hypertrophy During Antihypertensive Therapy Hypertension, July 1, 2008; 52(1): 100 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Mahadevan, R C Davis, M P Frenneaux, F D R Hobbs, G Y H Lip, J E Sanderson, and M K Davies Left ventricular ejection fraction: are the revised cut-off points for defining systolic dysfunction sufficiently evidence based? Heart, April 1, 2008; 94(4): 426 - 428. [Full Text] [PDF]
|
|
|
|
|
|
E. Gerdts, P. M. Okin, G. de Simone, D. Cramariuc, K. Wachtell, K. Boman, and R. B. Devereux Gender Differences in Left Ventricular Structure and Function During Antihypertensive Treatment: The Losartan Intervention for Endpoint Reduction in Hypertension Study Hypertension, April 1, 2008; 51(4): 1109 - 1114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Hill and E. N. Olson Cardiac Plasticity N. Engl. J. Med., March 27, 2008; 358(13): 1370 - 1380. [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Lang, M. Bierig, R. B. Devereux, F. A. Flachskampf, E. Foster, P. A. Pellikka, M. H. Picard, M. J. Roman, J. Seward, J. Shanewise, et al. Recommendations for chamber quantification Eur J Echocardiogr, March 1, 2006; 7(2): 79 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Berenji, M. H. Drazner, B. A. Rothermel, and J. A. Hill Does load-induced ventricular hypertrophy progress to systolic heart failure? Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H8 - H16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. de Simone, R. B Devereux, J. R Kizer, M. Chinali, J. N Bella, A. Oberman, D. W Kitzman, P. N Hopkins, D. Rao, and D. K Arnett Body composition and fat distribution influence systemic hemodynamics in the absence of obesity: the HyperGEN Study Am. J. Clinical Nutrition, April 1, 2005; 81(4): 757 - 761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Verdecchia, F. Angeli, R. Gattobigio, M. Sardone, and C. Porcellati Asymptomatic Left Ventricular Systolic Dysfunction in Essential Hypertension: Prevalence, Determinants, and Prognostic Value Hypertension, March 1, 2005; 45(3): 412 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Kizer, D. K. Arnett, J. N. Bella, M. Paranicas, D.C. Rao, M. A. Province, A. Oberman, D. W. Kitzman, P. N. Hopkins, J. E. Liu, et al. Differences in Left Ventricular Structure Between Black and White Hypertensive Adults: The Hypertension Genetic Epidemiology Network Study Hypertension, June 1, 2004; 43(6): 1182 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Wang, D. Levy, E. J. Benjamin, and R. S. Vasan The Epidemiology of "Asymptomatic" Left Ventricular Systolic Dysfunction: Implications for Screening Ann Intern Med, June 3, 2003; 138(11): 907 - 916. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Palmieri, P. M. Okin, J. N. Bella, E. Gerdts, K. Wachtell, J. Gardin, V. Papademetriou, M. S. Nieminen, B. Dahlof, and R. B. Devereux Echocardiographic Wall Motion Abnormalities in Hypertensive Patients With Electrocardiographic Left Ventricular Hypertrophy: The LIFE Study Hypertension, January 1, 2003; 41(1): 75 - 82. [Abstract] [Full Text] [PDF]
|
|