Abstract P051: Hypertension Is Associated With All-cause Mortality In Caucasians But Not African Americans With Suspected Cardiac Amyloidosis

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2022-09, Vol.79 (Suppl_1)
• Main Authors: Manjunath, Sonakshi, Deych, Elena, Lenihan, Daniel, Zhang, Kathleen
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.79.suppl_1.P051

Abstract only Background: Diagnostic delay is common among patients with cardiac amyloidosis. Hypertensive heart disease is a known echocardiographic mimic of cardiac amyloidosis, with greater prevalence among African Americans than among Caucasians. The association between hypertension and clinical outcomes in patients with suspected cardiac amyloidosis is not known. Objective: We sought to determine the association between a known diagnosis of hypertension and all-cause mortality in African Americans and Caucasians with suspected cardiac amyloidosis. Methods: We identified 230 patients who underwent cardiac biopsy for suspected cardiac amyloidosis at our institution between 2000-2018. Clinical and demographic data were obtained from the medical record. Echocardiograms performed at the time of cardiac biopsy were interpreted by study personnel. All-cause mortality was assessed using the Social Security Death Index. Results: Among 230 patients with suspected cardiac amyloidosis, hypertension was more common among African Americans (71 of 91, 78%) than among Caucasians (73 of 139, 52%). Over a median follow-up period of 4.5 months, the all-cause mortality rate was higher among Caucasians with hypertension (67%) than Caucasians without hypertension (42%, p= 0.048). There was no difference in all-cause mortality rate among African Americans with and without hypertension (47.8% vs. 50%, p=0.903). Among Caucasians, those with hypertension had increased posterior wall thickness, relative wall thickness, and interventricular septal thickness as compared to those without hypertension (p0.05). Conclusions: Hypertension and the hypertensive echocardiographic phenotype are associated with all-cause mortality in Caucasians but not African Americans with suspected cardiac amyloidosis. Additional study is needed to understand the differential effects of hypertension on clinical outcomes by racial category in patients with suspected cardiac amyloidosis.