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CLINICAL STUDY: RACE, GENDER, AND CAD

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

Richard Lorber, MD, Samuel S. Gidding, MD, FACC, Martha L. Daviglus, MD, PhD^*,*, Laura A. Colangelo, MS^*, Kiang Liu, PhD^* and Julius M. Gardin, MD, FACC

^* Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Nemours Cardiac Center, duPont Hospital for Children, Wilmington, Delaware, USA
Department of Pediatrics at the Cleveland Clinic, Cleveland, Ohio, USA
Division of Cardiology, Department of Medicine, University of California, Irvine, California, USA

Manuscript received June 28, 2002; revised manuscript received December 10, 2002, accepted December 12, 2002.

^* Reprint requests and correspondence: Dr. Martha L. Daviglus, 680 N. Lake Shore Drive, Suite 1102, Chicago, Illinois 60611, USA.
daviglus{at}northwestern.edu

OBJECTIVES: In the Coronary Artery Risk Development in Young Adults (CARDIA) Study comprised of a generally healthy, biracial cohort of 28- to 40-year-old adults, we sought to characterize the distribution of left ventricular (LV) mass and LV geometry and the relationship of systolic blood pressure (SBP), body mass index (BMI), and fasting insulin to LV mass and geometry.

BACKGROUND: Left ventricular mass is a risk factor for cardiovascular morbidity and mortality.

METHODS: Two-dimensionally guided M-mode echocardiograms were used to calculate LV mass index (g/height^2.7) and geometry.

RESULTS: Black men had highest LV mass index followed by white men, black women, and white women. Blacks had higher LV wall thickness/diameter ratios than whites. Left ventricular hypertrophy was present in 2% of the cohort. Going from highest to lowest quartile for LV mass index and LV wall thickness/diameter ratio, SBP and BMI were highest in those with the highest LV mass index and LV wall thickness/diameter ratio. Increasing BMI and SBP over a 10-year interval was also strongly related to LV structure in most race/gender groups.

CONCLUSIONS: In a generally healthy young adult cohort, LV structure as defined by LV mass and geometry is associated with SBP and BMI at levels generally considered normal.

Abbreviations and Acronyms   BMI   body mass index   CARDIA   Coronary Artery Risk Development in Young Adults   LV   left ventricle, left ventricular   LVIDd   left ventricular internal dimension at end-diastole   PWTd   left ventricular posterior wall thickness at end-diastole   SBP   systolic blood pressure   VSTd   ventricular septal thickness at end-diastole

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