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黑人和白人原发性高血压患者左心室质量与几何形态的比较。

Comparison of left ventricular mass and geometry in black and white patients with essential hypertension.

作者信息

Koren M J, Mensah G A, Blake J, Laragh J H, Devereux R B

机构信息

Department of Medicine, New York Hospital-Cornell Medical Center, NY 10021.

出版信息

Am J Hypertens. 1993 Oct;6(10):815-23. doi: 10.1093/ajh/6.10.815.

Abstract

To assess racial difference in cardiac responses to elevated blood pressure, we compared echocardiographic measurements of left ventricular (LV) mass and the wall thickness to chamber dimension ratio (relative wall thickness) in 380 white and 47 black patients with uncomplicated essential hypertension consecutively enrolled in echocardiographic research studies at The New York Hospital Hypertension Center. Diastolic blood pressure and weight were slightly greater in black as compared with white subjects (104 +/- 18 v 98 +/- 11 mm Hg; P = .014 and 82 +/- 17 v 77 +/- 15 kg; P = .037, respectively), however the groups were similar with respect to age, duration of hypertension, cholesterol level, cigarette smoking, past use of antihypertensive therapy, family history of heart disease, and height. On average, LV mass indexed for body surface area and relative wall thickness were significantly greater in blacks than whites (119 v 105 g/m2; P = .02 and 0.46 v 0.39; P = .003) and blacks had twice the prevalence of LV hypertrophy (41% v 19%; P < .001) or concentric remodeling (21% v 12%; P < .05). The magnitude of increased LV mass and relative wall thickness in blacks was similar in men (132 v 110 g/m2; P = .01 and 0.44 v 0.39; P = .04) and in women (107 v 94 g/m2; P = .11 and 0.48 v 0.39; P = .02). In multivariate analyses, systolic blood pressure, age, and race were consistently predictors of increased LV mass and abnormal cardiac geometry. Cholesterol level was not independently associated with increased LV mass but was weakly associated with increased relative wall thickness.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为评估血压升高时心脏反应的种族差异,我们比较了纽约医院高血压中心连续纳入超声心动图研究的380例白人及47例黑人原发性高血压患者的左心室(LV)质量的超声心动图测量值以及室壁厚度与腔径比值(相对室壁厚度)。与白人受试者相比,黑人的舒张压和体重略高(分别为104±18对98±11 mmHg;P = 0.014和82±17对77±15 kg;P = 0.037),然而两组在年龄、高血压病程、胆固醇水平、吸烟、既往抗高血压治疗史、心脏病家族史及身高方面相似。平均而言,黑人的体表面积指数左心室质量和相对室壁厚度显著高于白人(119对105 g/m²;P = 0.02和0.46对0.39;P = 0.003),黑人左心室肥厚(41%对19%;P < 0.001)或向心性重塑(21%对12%;P < 0.05)的患病率是白人的两倍。黑人左心室质量和相对室壁厚度增加的幅度在男性(132对110 g/m²;P = 0.01和0.44对0.39;P = 0.04)和女性(107对94 g/m²;P = 0.11和0.48对0.39;P = 0.02)中相似。在多变量分析中,收缩压、年龄和种族始终是左心室质量增加和心脏几何形状异常的预测因素。胆固醇水平与左心室质量增加无独立相关性,但与相对室壁厚度增加有弱相关性。(摘要截断于250字)

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