Author + information
- Received January 5, 2009
- Revision received August 7, 2009
- Accepted August 26, 2009
- Published online January 19, 2010.
- 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*,‡,* ()
- ↵*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
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.
This research was supported by contracts N01-HC-95159 and N01-HC-95168 from the National Heart, Lung, and Blood Institute. Dr. Rodriguez is supported by the Robert Wood Johnson Harold Amos Medical Faculty Development Program and a National Heart, Lung, and Blood Institute's Mentored Patient-Oriented Research Career Development Award (K23 HL079343-01A2). Christopher M. Kramer, MD, served as Guest Editor for this article.
- Received January 5, 2009.
- Revision received August 7, 2009.
- Accepted August 26, 2009.
- American College of Cardiology Foundation