Left Ventricular Systolic Dysfunction in a Biracial Sample of Hypertensive Adults

Abstract

To determine the prevalence and correlates of left ventricular systolic dysfunction in hypertensive patients in a biracial population-based sample, clinical evaluation and echocardiography were performed in 2086 participants in the Hypertension Genetic Epidemiology Network (HyperGEN) examination; 86% had normal ejection fraction (>54%), 10% had mild ventricular dysfunction (ejection fraction 41% to 54%), and 4% had severe ventricular dysfunction (ejection fraction ≤40%). Prevalences of mild and severe ventricular dysfunction were higher in men than women (14% versus 8% and 7% versus 3%, P P =0.07). Patients with severe ventricular dysfunction were older than those with mild dysfunction or normal function (mean, 58 versus 54 and 54 years, respectively; P =0.005) and had higher mean creatinine (1.20 versus 1.05 and 1.00 mg/dL) and uric acid (6.9 versus 6.3 and 6.1 mg/dL) levels (both P 2.7 ) and lower relative wall thickness (0.31 versus 33 and 0.35; all P P <0.0001). In regression analyses, lower ejection fraction as a continuous variable was independently and positively associated with male gender, diabetes, uric acid level, and body mass index. With the addition of echocardiographic variables, lower ejection fraction was associated with male gender, black race, prior myocardial infarction, and higher ventricular mass and lower relative wall thickness, pulse pressure, and body mass index. In a population-based sample of hypertensive patients, left ventricular systolic dysfunction was related to male gender, black race, diabetes, and elevated uric acid levels, as well as higher ventricular mass and lower relative wall thickness.