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CLINICAL RESEARCH: ETHNICITY AND LV HYPERTROPHY

Left Ventricular Mass and Ventricular Remodeling Among Hispanic Subgroups Compared With Non-Hispanic Blacks and Whites

MESA (Multi-Ethnic Study of Atherosclerosis)

Carlos J. Rodriguez, MD, MPH^_*,, Ana V. Diez-Roux, MD, PhD, Andrew Moran, MD, MPH^_*, Zhezhen Jin, PhD, Richard A. Kronmal, PhD^||, Joao Lima, MD^¶, Shunichi Homma, MD^_*, David A. Bluemke, MD, PhD^# and R. Graham Barr, MD, DrPH^_*,,_*

^_* Department of Medicine, Mailman School of Public Health, Columbia University, New York, New York
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
^|| Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, Washington
^¶ Department of Medicine, Johns Hopkins University, Baltimore, Maryland
^# Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland

Manuscript received January 5, 2009; revised manuscript received August 7, 2009, accepted August 26, 2009.

^_* Reprint requests and correspondence: Dr. R. Graham Barr, Columbia University, Department of Medicine, PH 9 East Room 105, 622 West 168th Street, New York, New York 10032 (Email: rgb9{at}columbia.edu).

Objectives: The purpose of this study was to examine the prevalence of left ventricular hypertrophy (LVH) and left ventricular (LV) remodeling patterns within Hispanic subgroups compared with non-Hispanic whites in the MESA (Multi-Ethnic Study of Atherosclerosis).

Background: Hispanics are the largest and fastest-growing ethnic minority in the U.S., but there are no data on LVH and LV geometry among Hispanic subgroups.

Methods: Cardiac magnetic resonance imaging was performed in 4,309 men and women age 45 to 84 years without clinical cardiovascular disease. Hispanics were categorized into subgroups based on self-reported ancestry. LVH was defined as the upper 95th percentile of indexed LV mass in a reference normotensive, nondiabetic, nonobese population, and LV remodeling according to the presence/absence of LVH and abnormal/normal LV mass to LV end-diastolic volume ratio.

Results: Among Hispanic participants, 574 were of Mexican origin, 329 were of Caribbean origin, and 161 were of Central/South American origin. On unadjusted analysis, only Caribbean-origin Hispanics (prevalence ratio = 1.2; 95% confidence interval [CI]: 1.03 to 1.4) had greater prevalence of hypertension than non-Hispanic whites. Hispanic subgroups were more likely to have LVH than non-Hispanic whites after adjustment for hypertension and other covariates (Caribbean-origin Hispanics = odds ratio [OR]: 1.8, 95% CI: 1.1 to 3.0; Mexican-origin Hispanics = OR: 2.2, 95% CI: 1.4 to 3.3; Central/South Americans = OR: 1.5, 95% CI: 0.7 to 3.1). All Hispanic subgroups also had a higher prevalence of concentric and eccentric hypertrophy compared with non-Hispanic whites (p < 0.001).

Conclusions: Caribbean-origin Hispanics had a higher prevalence of LVH and abnormal LV remodeling compared with non-Hispanic whites. A higher prevalence of LVH and abnormal LV remodeling was also observed among Mexican-origin Hispanics, despite a lower prevalence of hypertension. Differences among Hispanic subgroups regarding LVH and LV remodeling should be taken into account when evaluating cardiovascular risk in this population.

Key Words: hypertension • hypertrophy • remodeling • epidemiology • Hispanics • magnetic resonance imaging

Abbreviations and Acronyms   BMI = body mass index   CI = confidence interval   CV = cardiovascular   CVD = cardiovascular disease   LV = left ventricular   LVH = left ventricular hypertrophy   LVM = left ventricular mass   M-C = mass-cavity ratio   MRI = magnetic resonance imaging   OR = odds ratio   PR = prevalence ratio

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