RELATIONSHIP OF CARDIOVASCULAR RISK-FACTORS TO ECHOCARDIOGRAPHIC LEFT-VENTRICULAR MASS IN HEALTHY-YOUNG BLACK-AND-WHITE ADULT MEN AND WOMEN- THE CARDIA STUDY
Jm. Gardin et al., RELATIONSHIP OF CARDIOVASCULAR RISK-FACTORS TO ECHOCARDIOGRAPHIC LEFT-VENTRICULAR MASS IN HEALTHY-YOUNG BLACK-AND-WHITE ADULT MEN AND WOMEN- THE CARDIA STUDY, Circulation, 92(3), 1995, pp. 380-387
Background The objective of this study was to describe the distributio
n of echo left ventricular (LV) mass and its association with demograp
hic and cardiovascular risk factors in a large race- and sex-balanced
cohort of young adults. Recent epidemiological data have suggested tha
t M-mode echocardiographically determined LV hypertrophy is an indepen
dent predictor of mortality and morbidity from coronary heart disease
(CHD) in older adults. Echocardiographic LV mass has been associated i
n middle-aged and older adults with multiple factors including age, ar
terial blood pressure, body mass, and sex. However, there are few data
describing the distribution of echo LV mass among black and white you
ng adult men and women and relating LV mass to cardiovascular disease
risk factors within race-sex subgroups. Methods and Results CARDIA (Co
ronary Artery Risk Development in Young Adults) is a multicenter study
of young adults, including approximately equal proportions of black a
nd white men and women aged 23 to 35 years at the time of echo examina
tion (1990 through 1991). Two-dimensionally guided M-mode echocardiogr
ams were attempted in 4243 participants with recordings deemed accepta
ble for calculation of LV mass, that is, of at least fair quality scor
e, obtained in 3840 (90.5% of the 1990-1991 cohort). M-mode LV mass wa
s calculated from the formula of Devereux and Reichek, adapted for use
with measurements made according to the American Society of Echocardi
ography Standards. LV mass was greater in men than in women and greate
r in blacks than in whites (P<.001) (mean+/-SD): black men, 176+/-42 g
; white men, 169+/-40 g; black women, 135+/-38 g; and white women, 125
+/-33 g. In all race-sex groups, LV mass was positively correlated (P<
.0001) in bivariate analyses with body weight, subscapular skinfold th
ickness, height, and systolic blood pressure. In multivariate analyses
, LV mass remained independently and positively related to body weight
and systolic blood pressure and, when body weight was not considered,
with subscapular skinfold thickness and height. In addition, the mult
ivariate models allowed us to infer a direct relation between LV mass
and both fatness and lean body mass. Weaker positive associations were
noted of LV mass with pulse pressure in white participants and with p
hysical activity in men. After adjustment for subscapular skinfold thi
ckness, height, systolic and diastolic blood pressures, alcohol consum
ption, pulmonary function, smoking history, physical activity, total s
erum cholesterol, and family history of hypertension, LV mass remained
higher in men than in women (P<.0001), in black men (167+/-43 g) than
in white men (156+/-50 g, P<.0001), and in black women (142+/-49 g) t
han in white women (137+/-43 g, P<.002). Conclusions In the healthy yo
ung adults of the CARDIA cohort, LV mass was highly correlated with bo
dy weight, subscapular skinfold thickness, height, and systolic blood
pressure across race and sex subgroups. Furthermore, after adjustment
for anthropometric, blood pressure, and other covariates, LV mass rema
ined higher in men than in women and in blacks than in whites. Longitu
dinal studies are necessary to delineate the possible roles of these f
actors in the genesis of LV hypertrophy.