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非裔美国人的高血压与左心室结构和几何形态改变:杰克逊心脏研究

Hypertension and alterations in left ventricular structure and geometry in African Americans: the Jackson Heart Study.

作者信息

Abdalla Marwah, Booth John N, Diaz Keith M, Sims Mario, Muntner Paul, Shimbo Daichi

机构信息

Department of Medicine, Columbia University Medical Center, New York, NY, USA.

Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

J Am Soc Hypertens. 2016 Jul;10(7):550-558.e10. doi: 10.1016/j.jash.2016.05.010. Epub 2016 Jun 2.

Abstract

African Americans (AAs) have an increased risk for hypertension-related cardiovascular outcomes compared with whites, which may be related to abnormal left ventricular (LV) structure. We examined the association of prevalent hypertension with concentric remodeling (CR; normal LV mass index [LVMI] and increased relative wall thickness [RWT]), eccentric hypertrophy (increased LVMI and normal RWT), and concentric hypertrophy (CH; increased LVMI and increased RWT) within the Jackson Heart Study. Among 4721 participants (mean ± SD, age 55.7 ± 12.7 years), 2841 (60.2%) had prevalent hypertension, defined as mean clinic blood pressure ≥140/90 mm Hg or antihypertensive medication use. Prevalent hypertension was associated with a statistically significantly increased odds for having CR (odds ratio [OR] = 1.78, 95% confidence interval [CI] = 1.42-2.24), eccentric hypertrophy (OR = 1.68; 95% CI = 1.15-2.44), and CH (OR = 3.86, 95% CI = 2.28-6.54) after multivariable adjustment. In conclusion, in a population-based sample of AAs, hypertension was associated with increased odds for having abnormal LV structure, particularly CH.

摘要

与白人相比,非裔美国人(AA)患高血压相关心血管疾病的风险更高,这可能与左心室(LV)结构异常有关。我们在杰克逊心脏研究中研究了高血压患病率与向心性重塑(CR;正常左心室质量指数[LVMI]和相对壁厚度[RWT]增加)、离心性肥厚(LVMI增加和RWT正常)以及向心性肥厚(CH;LVMI增加和RWT增加)之间的关联。在4721名参与者(平均±标准差,年龄55.7±12.7岁)中,2841名(60.2%)患有高血压,定义为平均诊所血压≥140/90 mmHg或使用抗高血压药物。在多变量调整后,高血压患病率与CR(比值比[OR]=1.78,95%置信区间[CI]=1.42-2.24)、离心性肥厚(OR=1.68;95%CI=1.15-2.44)和CH(OR=3.86,95%CI=2.28-6.54)的发生几率在统计学上显著增加相关。总之,在以人群为基础的非裔美国人样本中,高血压与左心室结构异常(尤其是CH)的发生几率增加相关。

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