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(Hypertension. 2007;50:1033.)
© 2007 American Heart Association, Inc.
Original Articles |
From the Division of Cardiology (G.E.P.), University of Texas Southwestern Medical Center, Dallas; Cardiovascular Research Foundation (T.d.B., V.I., T.V.), New York, NY; Lenox Hill Hospital (A.G.), New York, NY; University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School (T.V.), New Brunswick, NJ; Johns Hopkins (L.J.A.), Baltimore, Md; University of Miami (G.C.), Fla; Biostatistics and Epidemiology (C.K.), Cleveland Clinic, Ohio; University of Alabama (S.R.), Birmingham; and the University of Massachusetts Memorial Medical Center and Medical School (R.A.P.), Worcester.
Correspondence to Gail E. Peterson, Division of Cardiology, University of Texas Southwestern Medical Center, 5909 Harry Hines Blvd, HA9.133, Dallas, TX 75235-9047. E-mail Gail.Peterson{at}UTSouthwestern.edu
African Americans with hypertensive renal disease represent a high-risk population for cardiovascular events. Although left ventricular hypertrophy is a strong predictor of adverse cardiac outcome, the prevalence and associated factors of left ventricular hypertrophy in this patient population are not well described. The African American Study of Kidney Disease Cohort Study is a prospective, observational study that is an extension of the African American Study of Kidney Disease randomized clinical trial that was conducted from 1994 to 2001 in African Americans with hypertension and mild-to-moderate renal dysfunction. Echocardiograms and 24-hour ambulatory blood pressure monitoring were performed at the baseline visit of the cohort. Of 691 patients enrolled in the cohort study, 599 patients had interpretable baseline echocardiograms and ambulatory blood pressure data. Left ventricular hypertrophy was defined using a cut point for left ventricular mass index >49.2 g/m2.7 in men and >46.7 m/m2.7 in women. The majority of patients had left ventricular hypertrophy (66.7% of men and 73.9% of women). In a multiple regression analysis, higher average day and nighttime systolic blood pressure, younger age, and lower predicted glomerular filtration rate were associated with left ventricular hypertrophy, but albuminuria was not. These data demonstrate a striking prevalence of left ventricular hypertrophy in the African American Study of Kidney Disease Cohort and identify potential targets for prevention and therapeutic intervention in this high-risk patient population.
Key Words: hypertension hypertrophy left ventricular echocardiography African Americans kidney failure chronic blood pressure monitoring ambulatory
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