Key result
African American race is not linked to higher LVH prevalence versus Caucasians in hypertensive children.
Why the study?
The impact of race on the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at diagnosis of essential hypertension in children was unknown.
Does African American race impact the prevalence of left ventricular hypertrophy and adaptation in children with newly diagnosed essential hypertension compared to Caucasians?
Cross-Sectional (n=422)
No
Does African American race impact the prevalence of left ventricular hypertrophy and adaptation in children with newly diagnosed essential hypertension compared to Caucasians?
In children with newly diagnosed essential hypertension, African American race is associated with concentric left ventricular adaptation but not with an increased prevalence of left ventricular hypertrophy, which is instead driven by obesity.
BACKGROUND: This is the first study to report on the impact of race on differences in the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at the time of diagnosis of essential hypertension in children. METHODS: This cross-sectional, single-centre study included patients aged 3-18 years who had newly diagnosed essential hypertension. Echocardiography was used to assess left ventricular mass index and left ventricular relative wall thickness. An left ventricular mass index > the 95th percentile for age and gender, and an left ventricular relative wall thickness > 0.42, were used to diagnose left ventricular hypertrophy and concentric adaptation. Various echocardiographic parameters were compared between African Americans and Caucasians. RESULTS: The study included 422 patients (289 African Americans and 133 Caucasians) diagnosed with essential hypertension at a median age of 14.6 (interquartile range; 12.1-16.3) years. Eighty-eight patients (20.9%) had left ventricular hypertrophy. There was no statistically significant difference in the prevalence of left ventricular hypertrophy between African Americans and Caucasians (22.5% versus 17.3%, p=0.22). The median left ventricular relative wall thickness was 0.35 (0.29-0.43), and 114 patients (27.0%) had an left ventricular relative wall thickness > 0.42. The presence of an left ventricular relative wall thickness > 0.42 was significantly higher among African Americans compared to Caucasians (30.1% versus 20.3%, p = 0.04). The African American race was a strong predictor for an left ventricular relative wall thickness > 0.42 (odds ratio 1.7, p = 0.04), but not for left ventricular mass index > the 95th percentile (p = 0.22). Overweight/obesity was a strong predictor for an left ventricular mass index > the 95th percentile. CONCLUSIONS: There was no difference in the prevalence of left ventricular hypertrophy in children with essential hypertension of different races. Obesity, rather than being African American, is associated with left ventricular hypertrophy.
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Takajo et al. (2023) conducted a cross-sectional in essential hypertension (n=422). African American race vs. Caucasian race was evaluated on left ventricular hypertrophy (p=0.22). African American race was not associated with a higher prevalence of left ventricular hypertrophy compared to Caucasians in children with essential hypertension (22.5% vs 17.3%, p=0.22).
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