Department of Neurology, University of Maryland School of Medicine, 655 West Baltimore Street- Rm12-006, Baltimore, MD 21201-1559, United States.
VA Maryland Health Care System, Baltimore, MD, United States; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
J Stroke Cerebrovasc Dis. 2022 Aug;31(8):106628. doi: 10.1016/j.jstrokecerebrovasdis.2022.106628. Epub 2022 Jul 4.
Few studies have addressed Black-White differences in left ventricular hypertrophy (LVH) in young stroke patients without a history of hypertension.
A case-only cross-sectional analysis performed in 2019 of data from the Stroke Prevention in Young Adults Study, a population-based case-control study of ischemic stroke patients ages 15-49. The main outcomes were hypertension indicators at the time of stroke hospitalization: self-reported history of hypertension, LVH by echocardiography (Echo-LVH) and LVH by electrocardiogram (ECG-LVH). The prevalence of Echo-LVH was further determined in those with and without a history of hypertension. Adjusted odds ratios and 95% confidence intervals comparing blacks and whites were calculated by logistic regression.
The study population included 1028 early-onset ischemic stroke patients, 48% Black cases, 54% men, median age 43 years (interquartile range, 38-46 years). Overall, the prevalence of hypertension history, Echo-LVH and ECG-LVH were 41.3%, 34.1% and 17.5%, respectively. Each of the hypertension indicators were more frequent in men than in women and in Black cases than in White cases. Black patients without a history of hypertension had higher rates of Echo-LVH than their white counterparts, 40.3% vs 27.7% (age and obesity adjusted OR 1.8; 95% CI 1.02-3.4) among men and 20.9% vs 7.6% (adjusted OR 2.7; 95% CI 1.2-6.2) among women.
LVH was common in young patients with ischemic stroke, regardless of self-reported history of hypertension. These findings emphasize the need for earlier screening and more effective treatment of hypertension in young adults, particularly in the Black population.
很少有研究探讨无高血压病史的年轻卒中患者中黑人和白人之间左心室肥厚（LVH）的差异。
这是一项 2019 年进行的病例对照横断面研究，研究对象为年龄在 15-49 岁的缺血性卒中患者，该研究来自基于人群的青年卒中预防研究（Stroke Prevention in Young Adults Study）。主要结局是卒中住院时的高血压指标：高血压病史、超声心动图（Echo-LVH）检测到的 LVH 和心电图（ECG-LVH）检测到的 LVH。在有或没有高血压病史的患者中进一步确定 Echo-LVH 的患病率。采用 logistic 回归计算比较黑人和白人的调整后比值比和 95%置信区间。
研究人群包括 1028 例早发性缺血性卒中患者，48%为黑人病例，54%为男性，中位年龄 43 岁（四分位距 38-46 岁）。总体而言，高血压病史、Echo-LVH 和 ECG-LVH 的患病率分别为 41.3%、34.1%和 17.5%。每个高血压指标在男性中的发生率均高于女性，在黑人病例中的发生率均高于白人病例。无高血压病史的黑人患者的 Echo-LVH 发生率高于白人患者，男性分别为 40.3%和 27.7%（年龄和肥胖调整后的比值比 1.8；95%CI 1.02-3.4），女性分别为 20.9%和 7.6%（调整后的比值比 2.7；95%CI 1.2-6.2）。
无论是否有高血压病史，缺血性卒中的年轻患者 LVH 均较常见。这些发现强调了在年轻人中，特别是在黑人中，需要更早地筛查和更有效地治疗高血压。
