RACIAL-DIFFERENCES IN AMBULATORY BLOOD-PRESSURE AND ECHOCARDIOGRAPHICLEFT-VENTRICULAR GEOMETRY

We examined the racial differences in left ventricular (LV) geometric pattern in relation to 24-hour ambulatory blood pressure (BP) monitori ng and the presence or absence of a nocturnal BP dip. Our study confir ms the blunting of nocturnal BP dip among black hypertensives. Body ma ss index, rather than race, was a major determinant of left ventricula r hypertrophy, We did not observe a difference in prevalence of left v entricular hypertrophy by race. However, left ventricular adaptation t o hypertension differed in hypertensive black and white individuals; w hereas most of the white patients with Stage 1-2 hypertension had a no rmal ventricular pattern, LV concentric remodeling and concentric hype rtrophy were the most common adaptive ventricular patterns in blacks w ith Stage 1-2 hypertension. A six-fold higher prevalence of concentric remodeling was observed in blacks as compared with whites. The impair ed nocturnal BP dip in blacks may contribute to the different hemodyna mic pattern. Determinants of myocardial oxygen consumption were signif icantly higher in black hypertensives.