Growth of Left Ventricular Mass in African American and European American Youth

Abstract

Abstract-Increased left ventricular mass has been established as a strong risk factor for cardiovascular morbidity and mortality. To evaluate growth of left ventricular mass from childhood into early adulthood and its possible sociodemographic, anthropometric, and hemodynamic moderators, individual growth curves across age of left ventricular mass were created for 687 African American and European American males and females with a maximum of 10 annual assessments (age, 8.2 to 27.5 years). African Americans and males had significantly greater left ventricular mass (PϽ0.001) than did European Americans and females, respectively. Males also showed a larger rate of change in left ventricle mass than did girls (PϽ0.001). The ethnicity and gender effects on left ventricular mass only became apparent in early adolescence, and they persisted when controlling for socioeconomic status and anthropometric and hemodynamic variables. Body mass index and height were the strongest anthropometric predictors, and pulse pressure was the strongest hemodynamic predictor of left ventricular mass. Although significant, the contribution of pulse pressure to the prediction of left ventricular mass was small, once body mass index and height were entered into the model. The results of the present study suggest that increased left ventricular mass in boys and African Americans has its origin in late childhood. Apart from these ethnicity and gender effects, individual differences in cardiac growth can mainly be explained by body growth and increases in general adiposity.

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

“…40,41 Apart from increased left ventricular mass in Africans, Li et al 44 indicated recently that African Americans have higher BP variability than European Americans, contradicting a small study performed in England (N¼26) that indicated no ethnic differences. 45 Li et al 44 argue that the higher BP variability values of Africans are consistent with the prognostic value of BP variability, and the higher incidence and mortality of cardiovascular disease in Africans.…”

“…41 Furthermore, Havranek et al 42 indicated that ECG left ventricular hypertrophy contributes more to the risk of cardiovascular mortality in African Americans than in Caucasians. They also suggested that left ventricular hypertrophy should be a target of therapy to reduce ethnic differences in cardiovascular mortality.…”

Candidate genes and growth curves for adiposity in African- and European-American youth

“…[10][11][12] Subject recruitment, evaluation and annualized attrition rate have been described previously. 11,15,16 The mean age of subjects at first visit was 11.0 years with a range of 3.9-23.9 years.…”

“…12,31 Individual growth curves in adiposity are characterized by their intercept (or level) and slope (rate of change). As described in detail previously, 10 we modeled the effects of age, age 2 , 3 .…”

“…10 Two previous studies of the same cohort 11,12 showed that general adiposity was the most important predictor of systolic blood pressure and left ventricular mass development across a 10-year period, suggesting that obese children are at higher risk of developing hypertension and left ventricular hypertrophy as adults. These findings help to illustrate the pivotal role that juvenile obesity prevention could play in managing and controlling cardiovascular disease (CVD) risk in adulthood.…”