BLACK-WHITE DIFFERENCES IN ELECTROCARDIOGRAPHIC LEFT-VENTRICULAR MASSAND ITS ASSOCIATION WITH BLOOD-PRESSURE (THE ARIC STUDY)

Black-white differences in the association between antihypertensive th erapy, continuous measures of mean arterial and pulse pressures and le ft ventricular (LV) mass estimated from a multivariable electrocardiog raphic algorithm were examined in 6,020 men (23% black) and 7,970 wome n (29% black) participating in the Atherosclerosis Risk in Communities (ARIC) study. Mean arterial and pulse pressures, weight, the percenta ge of subjects taking antihypertensive medication, and LV mass were hi gher in black than in white men (98 vs 89 mm Hg, 47 vs 46 mm Hg, 188 v s 187 pounds, 30% vs 17%, and 243 vs 217 g, respectively). Results of similar direction but greater magnitude were observed in black versus white women (mean arterial pressure, 94 vs 85 mm Hg; pulse pressure, 5 0 vs 47 mm Hg; weight, 180 vs 153 pounds; percent treated, 42% vs 18%; and LV mass, 203 vs 169 g, respectively). In multivariable regression analyses, blacks had higher levels of LV mass, and LV mass increased more sharply with increasing mean arterial pressure in blacks than in whites after adjusting for age, pulse pressure, and weight. At equal m ean arterial and pulse pressures, age, and weight, treated blacks had higher LV mass than treated whites. These data indicate that blacks ha ve higher LV mass than whites, and a more pronounced blood pressure-LV mass relation after controlling for other risk factors acid treatment status. Given the prognostic importance of LV hypertrophy, intensifie d efforts to understand the ethnic differentials in LV mass may provid e strategies to reduce excess cardiovascular mortality in African-Amer icans.