COMPARISON OF LEFT-VENTRICULAR MASS AND GEOMETRY IN BLACK-AND-WHITE PATIENTS WITH ESSENTIAL-HYPERTENSION

To assess racial difference in cardiac responses to elevated blood pre ssure, we compared echocardiographic measurements of left ventricular (LV) mass and the wall thickness to chamber dimension ratio (relative wall thickness) in 380 white and 47 black patients with uncomplicated essential hypertension consecutively enrolled in echocardiographic res earch studies at The New York Hospital Hypertension Center. Diastolic blood pressure and weight were slightly greater in black as compared w ith white subjects (104 +/- 18 v 98 +/- 11 mm Hg; P = .014 and 82 +/- 17 v 77 +/- 15 kg; P = .037, respectively), however the groups were si milar with respect to age, duration of hypertension, cholesterol level , cigarette smoking, past use of antihypertensive therapy, family hist ory of heart disease, and height. On average, LV mass indexed for body surface area and relative wall thickness were significantly greater i n blacks than whites (119 v 105 g/m2; p = .02 and 0.46 v 0.39; P = .00 3) and blacks had twice the prevalence of LV hypertrophy (41% v 19%; P < .001) or concentric remodeling (21% v 12%; P < .05). The magnitude of increased LV mass and relative wall thickness in blacks was similar in men (132 v 110 g/m2; p =.01 and 0.44 v 0.39; P = .04) and in women (107 v 94 g/m2; p = .11 and 0.48 v 0.39; P = .02). In multivariate an alyses, systolic blood pressure, age, and race were consistently predi ctors of increased LV mass and abnormal cardiac geometry. Cholesterol level was not independently associated with increased LV mass but was weakly associated with increased relative wall thickness. We conclude that black hypertensives are more likely to exhibit adverse changes in LV mass and geometry which may contribute to the higher risk of sudde n cardiac death and myocardial infarction case fatality rates found in blacks as compared to whites.