Influence of systolic blood pressure and body mass index on left ventricular structure in healthy African-American and white young adults: the CARDIA study

Abstract Objective: To evaluate the association of systolic blood pressure percentile, race, and body mass index with left ventricular hypertrophy on electrocardiogram and echocardiogram to define populations at risk. Study design: This is a retrospective cross-sectional study design utilising a data analytics tool (Tableau) combining electrocardiogram and echocardiogram databases from 2003 to 2020. Customized queries identified patients aged 2–18 years who had an outpatient electrocardiogram and echocardiogram on the same date with available systolic blood pressure and body measurements. Cases with CHD, cardiomyopathy, or arrhythmia diagnoses were excluded. Echocardiograms with left ventricle mass (indexed to height2.7) were included. The main outcome was left ventricular hypertrophy on echocardiogram defined as Left ventricle mass index greater than the 95th percentile for age. Results: In a cohort of 13,539 patients, 6.7% of studies had left ventricular hypertrophy on echocardiogram. Systolic blood pressure percentile >90% has a sensitivity of 35% and specificity of 82% for left ventricular hypertrophy on echocardiogram. Left ventricular hypertrophy on electrocardiogram was a poor predictor of left ventricular hypertrophy on echocardiogram (9% sensitivity and 92% specificity). African American race (OR 1.31, 95% CI = 1.10, 1.56, p = 0.002), systolic blood pressure percentile >95% (OR = 1.60, 95% CI = 1.34, 1.93, p < 0.001), and higher body mass index (OR = 7.22, 95% CI = 6.23, 8.36, p < 0.001) were independently associated with left ventricular hypertrophy on echocardiogram. Conclusions: African American race, obesity, and hypertension on outpatient blood pressure measurements are independent risk factors for left ventricular hypertrophy in children. Electrocardiogram has little utility in the screening for left ventricular hypertrophy.

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Abstract 15047: Effects of Blood Pressure Percentile, Body Mass Index, and Race on Left Ventricular Mass in Children

Circulation ◽

10.1161/circ.142.suppl_3.15047 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Michelle L Udine ◽

Jonathan Kaltman ◽

Qianxi Li ◽

Jin Liu ◽

Deyu Sun ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

African American ◽

Body Mass ◽

Left Ventricular ◽

Left Ventricle Mass ◽

Cross Sectional ◽

Populations At Risk ◽

African American Race

Introduction: Childhood hypertension, obesity, and left ventricular hypertrophy (LVH) are risk factors for premature cardiovascular events in adulthood, particularly among minorities. In children, race and body mass index (BMI) have been shown to be independently associated with LVH, with conflicting data on the association of systolic blood pressure (SBP) level with risk of LVH and utility of ECG in assessing LVH. This study looks at the association of SBP percentile, race, and BMI with LVH on electrocardiogram (ECG) and echocardiogram (echo) to define populations at risk. Methods: This is a retrospective cross-sectional study design utilizing a data analytics tool (Tableau) combining ECG and echo databases from 2003-2020. Customized queries identified patients ages 2-18 years old who had an outpatient ECG and echo on the same date with available SBP and body measurements. Cases with congenital heart disease, cardiomyopathy, or arrhythmia diagnoses were excluded. Echos with left ventricle mass (indexed to height 2.7 ) were included. The main outcome was LVH on echo defined as LV mass index greater than the 95 th percentile for age. Results: In a cohort of 13,926 patients, 6.9% of studies had LVH on echo. SBP percentile > 90% has a sensitivity of 36% and specificity of 82% for LVH on echo. LVH on ECG was a poor predictor of LVH on echo (9% sensitivity and 92% specificity). African American race (OR 1.31, 95% CI = 1.11, 1.55, p=.001), SBP percentile > 95% (OR=1.64, 95% CI = 1.37, 1.95, p <.001), and higher body mass index (OR= 7.43, 95% CI = 6.44, 8.55, p <.001) were independently associated with LVH on echo. Figure 1 shows the prevalence of LVH by African American race, obesity, and SBP. Conclusions: African American race, obesity, and hypertension are independent risk factors for LVH in children. Outpatient ECG has low utility in screening for LVH.

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FREQUENCY AND RISK FACTORS OF LEFT VENTRICULAR GEOMETRIC ABNORMALITIES IN HYPERTENSIVE PATIENTS: A STUDY BASED ON THE UPDATED CLASSIFICATION SYSTEM OF LEFT VENTRICULAR GEOMETRY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6002 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S695-700

Author(s):

Fauzia Nazir ◽

Tahir Iqbal ◽

Javeria Kamran ◽

Tariq Hussain Khattak ◽

Anum Fatima ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Body Mass Index ◽

Left Ventricular Hypertrophy ◽

Systolic Blood Pressure ◽

Body Mass ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Concentric Left Ventricular Hypertrophy ◽

Elevated Systolic Blood Pressure

Objective: To determine the association between cardiovascular risk factors and the abnormalities of left ventricular geometric abnormalities. Study Design: Prospective cross-sectional, single centered study. Place and Duration of Study: Armed Forces Institute of Cardiology, Rawalpindi, from Jun 2018 to Dec 2018. Methodology: This study permission was sought from hospital ethics committee. Written informed consent was taken from participants of study. Particulars of all the patients who meet the inclusion were included i.e., 351 hypertensive. Results: Left ventricular geometric abnormalities were detected in 321 subjects (91%), wherein concentric non dilated left ventricular hypertrophy is the most common left ventricular geometric abnormality (39%). Elevated systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular remodeling, whereas body mass index and chronic kidney disease were inversely associated with concentric abnormalities. systolic blood pressure and diabetes mellitus, chronic kidney disease, large WC were positively associated with eccentric dilated left ventricular hypertrophy, while body mass index, duration of hypertension, MS were inversely associated with eccentric dilated left ventricular hypertrophy. Elevated systolic blood pressure was the strongest risk factor for eccentric dilated left ventricular hypertrophy. Large WC, systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular hypertrophy, whereas body mass index was negatively associated with concentric left ventricular hypertrophy. Conclusion: Appropriate risk factor management and compliance can prevent left ventricular geometric abnormalities hence poorer outcomes in our population

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