Relation of Blood Pressure Components to Left Ventricular Hypertrophy and Coronary Heart Disease with Aging

2004 ◽  
Vol 34 (2) ◽  
pp. 142 ◽  
Author(s):  
Jae Suk Park ◽  
Chang Gyu Park ◽  
Mi Young Park ◽  
Jae Hyoung Park ◽  
Yong Hyun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular

Abstract P369: Left Ventricular Hypertrophy and Coronary Heart Disease Risk Reclassification in Blacks and Whites: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Tochi Okwuosa ◽  
Elsayed Z Soliman ◽  
Alvaro Alonso ◽  
Kim A Williams ◽  
Faye Lopez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Risk Model ◽  
Left Ventricular ◽  
C Statistic ◽  
Framingham Risk ◽  
Ecg Score

Introduction: Left ventricular hypertrophy (LVH) is more prevalent in blacks than whites, and is a major independent predictor of coronary heart disease (CHD)/CVD survival in blacks. We evaluated the ability of LVH to predict CHD outcomes beyond traditional cardiovascular risk factors in blacks, compared with whites from a large community-based cohort. Methods: Data were analyzed on 14,489 participants (mean age 54 +/- 5.7 years, 43.5% men, and 26% black) within the ARIC cohort, with baseline (1987-1989) electrocardiograms (ECG), followed through 2009. Risk estimates for incident CHD were assessed using the 10-year Framingham Risk Score (FRS). Model 1 was the Framingham base model, while model 2 included the base model plus LVH by any of 11 traditional ECG-LVH criteria (Table). Net reclassification improvement (NRI) was calculated, and the distribution of risk was compared using model 2 vs. model 1. Results: There were 690 (4.8%) 10-year and 1515 (10.5%) 20-year CHD events. LVH defined by any criteria was associated with CHD events in the entire cohort [HR (95% CI): 1.42 (1.20-1.7)]. LVH defined by the Framingham ECG score and LV strain criteria were the criteria most associated with CHD overall. LVH by Framingham ECG score was most associated with CHD in blacks [HR (95%CI): 2.53 (1.65-3.89)], while LV strain showed the strongest association with CHD in whites [1.73 (1.18-2.56)]. No statistically significant improvement in NRI or C-statistic was observed in model 2 [C-statistic (95% CI): 0.779 (0.763-0.794), NRI = 0.006 (p = 0.41)], compared with the base model [0.777 (0.762-0.792)]; and no racial interactions were observed. Findings were unchanged when the base model was replaced with the 10 and 20-year ARIC risk model (includes diabetes) for CHD. Conclusions: In this cohort of black and white men and women, LVH (defined by ECG) was significantly associated with CHD after adjustment for FRS; but did not significantly improve CHD risk prediction beyond the FRS. No significant black-white differences in risk prediction were observed. Table. Reclassification of Coronary Heart Disease by the addition of each Criterion for Left Ventricular Hypertrophy, based on a 10-year Framingham Risk Model * Base model factors in age, gender, current smoking, diabetes, systolic blood pressure, diastolic blood pressure, HDL cholesterol and total cholesterol as separate variables. * NRI categorized as <10%, 10-20% and >20%. Abbreviations: NRI = Net Reclassification Index, IDI = Integrated Discrimination Index, HR = Hazard Ratio, CI = Confidence Interval

Reduced Vital Capacity in Elderly Persons With Hypertension, Coronary Heart Disease, or Left Ventricular Hypertrophy

CHEST Journal ◽  
1995 ◽  
Vol 107 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Paul L. Enright ◽  
Richard A. Kronmal ◽  
Vivienne-Elizabeth Smith ◽  
Julius M. Gardin ◽  
Marc B. Schenker ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Vital Capacity ◽  
Left Ventricular ◽  
Elderly Persons

Abstract P274: FGF-23 is Associated with Left Ventricular Hypertrophy and Systolic Dysfunction among Patients with Coronary Heart Disease: The Heart and Soul Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Isha Agarwal ◽  
Joachim Ix ◽  
Bryan Kestenbaum ◽  
Nelson Schiller ◽  
Mary Whooley ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Left Ventricular Mass ◽  
Kidney Function ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Concentric Hypertrophy ◽  
Fgf 23

Introduction: Fibroblast growth factor-23 (FGF-23) is a bone-derived phosphaturic hormone strongly associated with cardiovascular mortality and left ventricular hypertrophy among individuals with end-stage renal disease (ESRD). Whether the relationship between FGF-23 and cardiac dysfunction extends to participants without ESRD is not clearly established. Hypothesis: We tested whether FGF-23 is associated with left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in participants with coronary heart disease (CHD) and a broad range of kidney function in the Heart and Soul Study. Methods and Results: In cross-sectional analyses of 887 participants of the Heart and Soul Study, FGF-23 was positively associated with LVMI (2.09 g/m 2 , 95% confidence interval [CI] 0.15 to 4.03 per 1 standard-deviation [SD] higher ln FGF-23) and inversely associated with LVEF (-0.96%, CI -1.71% to -0.21%, per 1 SD higher ln FGF-23) after adjustment for age, CHD risk factors, microalbuminuria, and cystatin-based estimated glomerular filtration rate (eGFR). In multinomial logistic regression, FGF-23 was associated with an increased prevalence of concentric hypertrophy (odds ratio 1.66, CI 1.00 to 2.76, per 1 SD increase in ln FGF-23) but not eccentric hypertrophy (odds ratio 1.14, CI 0.96 to 1.36). The association between FGF-23 and concentric hypertrophy was stronger among individuals with an estimated GFR < 60 mL/min per 1.73 m 2 , and was not statistically significant among individuals with normal to mildly reduced kidney function (Figure, p interaction 0.11). Conclusion: In conclusion, FGF-23 was associated with greater left ventricular mass and concentric hypertrophy, particularly among individuals with diminished kidney function. Additional studies are necessary to determine the pathways that mediate this association.

scholarly journals Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults

Hypertension ◽  
2019 ◽  
Vol 74 (5) ◽  
pp. 1192-1199 ◽  
Author(s):  
Florian Rader ◽  
Stanley S. Franklin ◽  
James Mirocha ◽  
Wanpen Vongpatanasin ◽  
Robert W. Haley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Office Blood Pressure ◽  
Black Adults ◽  
Black And White ◽  
White Adults

Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34–1.64 for out-of-office systolic BP and 1.15 [1.04–1.28] for clinic systolic BP; 1.71 [1.43–2.05] for out-of-office diastolic BP, and 1.03 [0.86–1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT00344903.

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