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Submitted on October 21, 2003
From the Department of Medicine (C.J.R., R.R.S., S.H., M.R.D.), Columbia University, New York, NY; Department of Epidemiology (A.V.D.-R.), University of Michigan, Ann Arbor; Neurological Institute (B.B.-A., R.L.S.), Columbia University, New York, NY; Division of Epidemiology (R.L.S.), Columbia University Mailman School of Public Health, New York, NY; Department of Sociomedical Science (B.B.-A.), Columbia University Mailman School of Public Health, New York, NY; and Sergievsky Center (R.L.S.), College of Physicians & Surgeons, Columbia University, New York, NY. * To whom correspondence should be addressed. E-mail: cjr10{at}columbia.edu.
Abstract--Increased left ventricular mass (LVM) and lower socioeconomic status (SES) are predictors of cardiovascular morbidity and mortality. Blacks and Hispanics are more likely to have higher LVM and lower SES. The relation between SES, race-ethnicity, and LVM has not been fully explored. Data were used from the NOMAS population-based sample of 1916 subjects living in Northern Manhattan. SES was characterized on the basis of educational attainment and divided into 4 categories. Echocardiography-defined LVM was indexed according to height at the allometric power of 2.7 and analyzed as a continuous variable. LVM varied by race in our cohort (blacks 48.9 g/m2.7, Hispanics 48.4 g/m2.7, whites 45.6 g/m2.7; P=0.004). Using ANCOVA, there was a significant inverse and graded association between mean LVM and SES for the total cohort. Mean LVM was 48.4 g/m2.7, 48.6 g/m2.7, 47.1 g/m2.7, and 45.3 g/m2.7 for the lowest to the highest educational level category (P trend=0.0004). This relationship remained among normotensives (P trend=0.0005) and was present for blacks (P trend=0.009), but not for whites (P trend=0.86) or Hispanics (P trend=0.47). The difference in mean LVM between the highest and lowest categories of education was 5.3 g/m2.7 for blacks, 0.0 g/m2.7 for whites, and 1.0 g/m2.7 for Hispanics. Lower SES is an independent predictor of increased LVM among hypertensive and normotensive blacks.
Revised on November 19, 2003
Relation Between Socioeconomic Status, Race-Ethnicity, and Left Ventricular Mass. The Northern Manhattan Study
Carlos J. Rodriguez*;
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