Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences University of Abuja, Nigeria.
Am J Hypertens. 2017 Nov 1;30(11):1083-1092. doi: 10.1093/ajh/hpx114.
The association of electrocardiographic left ventricular hypertrophy (ECG-LVH) with blood pressure (BP) in Blacks living in sub-Saharan Africa remains poorly documented.
In 225 Black Nigerians and 729 White Flemish, we analyzed QRS voltages and voltage-duration products and 12 criteria diagnostic of ECG-LVH in relation to office BP (mean of 5 consecutive readings) and home BP (duplicate morning and evening readings averaged over 1 week).
In multivariable analyses, QRS voltage and voltage-duration indexes were generally higher in Blacks than Whites. By using any of 12 criteria, ECG-LVH was more prevalent among Black than White men (54.4% vs. 36.0%) with no ethnic difference among women (17.1%). Precordial voltages and voltage-duration products increased with office and home systolic BP (SBP), and increases were up to 3-fold steeper in Blacks. In Blacks vs. Whites, increases in the Sokolow-Lyon voltage associated with a 10-mm Hg higher SBP were 0.18 mV (95% confidence interval [CI], 0.09-0.26) vs. 0.06 mV (0.02-0.09) and 0.17 mV (0.07-0.28) vs. 0.11 mV (CI, 0.07-0.15) for office and home BP, respectively, with a significant ethnic gradient (P < 0.05). The risk of ECG-LVH increased more with office and home BP in Blacks than Whites.
Associations of ECG voltages and voltage-duration products and risk of ECG-LVH with BP are steeper in Black Nigerians compared with a White reference population. In resource-poor settings of sub-Saharan Africa, the ECG in combination with office and home BP is an essential instrument in risk stratification across the entire BP range.
心电图左心室肥厚（ECG-LVH）与居住在撒哈拉以南非洲的黑人的血压（BP）之间的关联仍鲜有记录。
在 225 名黑人尼日利亚人和 729 名白人佛兰芒人中，我们分析了 QRS 电压和电压-时间乘积，并根据诊室血压（连续 5 次读数的平均值）和家庭血压（平均 1 周内早晚各测量 2 次的平均值）分析了 12 项心电图 LVH 诊断标准。
在多变量分析中，黑人的 QRS 电压和电压-时间指数通常高于白人。无论使用哪 12 项标准，黑人男性中 ECG-LVH 的患病率都高于白人男性（54.4%对 36.0%），而女性中无种族差异（17.1%）。胸前导联电压和电压-时间乘积随诊室和家庭收缩压（SBP）升高而升高，黑人的升高幅度高达 3 倍。与每升高 10mmHg 的 SBP 相关的 Sokolow-Lyon 电压在黑人中的升高幅度为 0.18mV（95%可信区间[CI]，0.09-0.26），而在白人中为 0.06mV（0.02-0.09），对于诊室和家庭 BP，分别为 0.17mV（0.07-0.28）对 0.11mV（CI，0.07-0.15），且存在显著的种族梯度（P <0.05）。与白人相比，ECG-LVH 的风险随着黑人诊室和家庭 BP 的升高而增加更多。
与白人参考人群相比，黑人尼日利亚人 ECG 电压和电压-时间乘积以及与 BP 相关的 ECG-LVH 风险的关联更为陡峭。在撒哈拉以南非洲资源匮乏的环境中，心电图结合诊室和家庭 BP 是整个 BP 范围内进行风险分层的重要手段。
