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- Title
Office and Home Blood Pressures as Determinants of Electrocardiographic Left Ventricular Hypertrophy Among Black Nigerians Compared With White Flemish.
- Authors
Odili, Augustine N.; Thijs, Lutgarde; Wen-Yi Yang; Ogedengbe, John O.; Nwegbu, Maxwell M.; Jacobs, Lotte; Fang-Fei Wei; Ying-Mei Feng; Zhen-Yu Zhang; Kuznetsova, Tatiana; Nawrot, Tim S.; Staessen, Jan A.
- Abstract
BACKGROUND The association of electrocardiographic left ventricular hypertrophy (ECG-LVH) with blood pressure (BP) in Blacks living in sub-Saharan Africa remains poorly documented. METHODS In 225 Black Nigerians and 729 White Flemish, we analyzed QRS voltages and voltage-duration products and 12 criteria diagnostic of ECGLVH in relation to office BP (mean of 5 consecutive readings) and home BP (duplicate morning and evening readings averaged over 1 week). RESULTS In multivariable analyses, QRS voltage and voltage-duration indexes were generally higher in Blacks than Whites. By using any of 12 criteria, ECGLVH was more prevalent among Black than White men (54.4% vs. 36.0%) with no ethnic difference among women (17.1%). Precordial voltages and voltage-duration products increased with office and home systolic BP (SBP), and increases were up to 3-fold steeper in Blacks. In Blacks vs. Whites, increases in the Sokolow-Lyon voltage associated with a 10-mm Hg higher SBP were 0.18 mV (95% confidence interval [CI], 0.09-0.26) vs. 0.06 mV (0.02-0.09) and 0.17 mV (0.07-0.28) vs. 0.11 mV (CI, 0.07-0.15) for office and home BP, respectively, with a significant ethnic gradient (P < 0.05). The risk of ECG-LVH increased more with office and home BP in Blacks than Whites. CONCLUSIONS Associations of ECG voltages and voltage-duration products and risk of ECG-LVH with BP are steeper in Black Nigerians compared with a White reference population. In resource-poor settings of sub-Saharan Africa, the ECG in combination with office and home BP is an essential instrument in risk stratification across the entire BP range.
- Subjects
BLOOD pressure; VASCULAR resistance; ARTERIAL abnormalities; ELECTROCARDIOGRAPHY; HYPERTROPHY
- Publication
American Journal of Hypertension, 2017, Vol 30, Issue 11, p1083
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpx114