Key result
Early hypertension in black African patients is linked to ~10-fold higher odds of left atrial enlargement.
Why the study?
Left atrial remodelling and its associated factors have been poorly elucidated in sub-Saharan African hypertensive subjects, despite hypertension occurring earlier and more severely in this region.
Is early-phase hypertension associated with left atrial remodelling in black African patients?
Cross-Sectional
Is early-phase hypertension associated with left atrial remodelling in black African patients?
Odds Ratio: 9.78 (95% CI 2.67–35.8)
Absolute Event Rate: 26.9% vs 2.5%
p-value: p=<0.0001
Newly diagnosed hypertension in black African patients is associated with significant early left atrial remodelling, driven independently by diastolic dysfunction.
May prompt earlier echo assessment in black African patients with new hypertension; leaves open whether remodelling predicts outcomes or responds to therapy.
BACKGROUND: Left atrial remodelling (LAR) has been described in Western populations with chronic hypertension and is associated with a higher risk of adverse cardiovascular events. Although hypertension tends to occur earlier and is more severe in sub-Saharan Africa than in more developed nations, LAR and its associated factors in these African hypertensive subjects have been poorly elucidated. OBJECTIVES: To assess left atrial structural remodelling in black hypertensive patients and determine factors associated with left atrial size. METHODS: . Early morning urine was analysed for microalbuminuria using urine strips to obtain spot albumin/creatinine ratio. Data were analysed using SPSS version 23 and statistical significance was set at p < 0.05. RESULTS: ; p = 0.003) and volume (52.4 vs 43.8 ml; p = 0.002) compared to the non-hypertensive counterparts. Fourteen patients (26.9%) had LA enlargement compared to one (2.5%) in the non-hypertensive group (odds ratio = 9.78, CI: 2.67-35.8, p < 0.0001). Diastolic dysfunction (p = 0.008) was the only independent predictor of LA size in the hypertensive subjects. Microalbuminuria did not significantly correlate with LA size. CONCLUSIONS: Our study shows evidence of LAR in newly diagnosed black African patients with hypertension, characterised by an increase in the LA length, surface area and volume. Future studies are warranted to better elucidate the biological mechanisms underlying the link between the early phase of hypertension and LAR, as well as its prognostic implications in our population.
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Gounoue et al. (2020) conducted a cross-sectional in Hypertension. Hypertension vs. Non-hypertensive controls was evaluated on Left atrial enlargement (OR 9.78, 95% CI 2.67-35.8, p=<0.0001). Early phase hypertension in black African patients was associated with significantly higher odds of left atrial enlargement compared to non-hypertensive controls (26.9% vs 2.5%; OR 9.78, CI 2.67-35.8).
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