Left ventricular systolic dysfunction in a biracial sample of hypertensiveadults - The HyperGEN study

To determine the prevalence and correlates of left ventricular systolic dys function in hypertensive patients in a biracial population-based sample, cl inical evaluation and echocardiography were performed in 2086 participants in the Hypertension Genetic Epidemiology Network (HyperGEN) examination; 86 % had normal ejection fraction (>54%), 10% had mild ventricular dysfunction (ejection fraction 41% to 54%), and 4% had severe ventricular dysfunction (ejection fraction less than or equal to 40%). Prevalences of mild and seve re ventricular dysfunction were higher in men than women (14% versus 8% and 7% versus 3%, P<0.001) and, weakly, in diabetics than nondiabetics (13% ve rsus 10% and 6% versus 4%, P=0.07). Patients with severe ventricular dysfun ction were older than those with mild dysfunction or normal function (mean, 58 versus 54 and 54 years, respectively; P=0.005) and had higher mean crea tinine (1.20 versus 1.05 and 1.00 mg/dL) and uric acid (6.9 versus 6.3 and 6.1 mg/dL) levels (both P<0.001). Those with severe ventricular dysfunction , compared with those with mild dysfunction or normal ejection fraction, ha d greater mean ventricular internal dimension (6.2 versus 5.6 and 5.1 cm) a nd mass (61 versus 50 and 43 g/m(2.7)) and lower relative wall thickness (0 .31 versus 33 and 0.35; all P<0.0001). Severe and mild ventricular dysfunct ion was associated with lower myocardial contractility (mean stress-correct ed midwall shortening, 68% versus 94% versus 106% of predicted; P<0.0001). In regression analyses, lower ejection fraction as a continuous variable wa s independently and positively associated with male gender, diabetes, uric acid level, and body mass index. With the addition of echocardiographic var iables, lower ejection fraction was associated with male gender, black race , prior myocardial infarction, and higher ventricular mass and lower relati ve wall thickness, pulse pressure, and body mass index. In a population-bas ed sample of hypertensive patients, left ventricular systolic dysfunction w as related to male gender, black race, diabetes, and elevated uric acid lev els, as well as higher ventricular mass and lower relative wall thickness.