Low Grade Inflammation and ECG Left Ventricular Hypertrophy in Urban African Males: The SABPA Study

Background Hypertension and vascular hyperresponsiveness have been associated with structural wall abnormalities in black Africans. Whether low grade inflammation would have an additive effect is uncertain. Therefore, a novel investigation aimed to assess whether inflammation and pressure overload w...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2013-11, Vol.22 (11), p.924-929
Main Authors: van der Walt, Carel, BSc Hons, Malan, Leoné, RN, PhD, Uys, Aletta S., PhD, Malan, Nicolaas T., DSc
Format: Article
Language:English
Subjects:
Adult
African Continental Ancestry Group
Aged
Blood Pressure
Cardiovascular
Electrocardiography
Ethnicity
European Continental Ancestry Group
Humans
Hypertrophy, Left Ventricular - ethnology
Hypertrophy, Left Ventricular - physiopathology
Inflammation
Left ventricular hypertrophy
Male
Middle Aged
South Africa
Urban Population
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Summary:Background Hypertension and vascular hyperresponsiveness have been associated with structural wall abnormalities in black Africans. Whether low grade inflammation would have an additive effect is uncertain. Therefore, a novel investigation aimed to assess whether inflammation and pressure overload would have an additive association with ECG left ventricular hypertrophy (LVH). Methods We included 75 African and 87 Caucasian males. Ambulatory blood pressure monitoring was done in the working week. A resting 12-lead ECG recording was used for the determination of LVH with the Cornell product formula. Fasting blood samples were obtained for high sensitivity C-reactive protein (hs-CRP) analyses after a controlled overnight stay. Men were stratified into low (≤3 mg/L) and high (>3 mg/L) hs-CRP groups. Results African men revealed higher ambulatory blood pressure levels compared to Caucasian men independent of hs-CRP levels after adjustment for age, physical activity, cotinine, log γ-GT and body surface area. In forward stepwise linear regression analyses, SBP was positively associated with ECG LVH in all Africans. Considering low grade inflammatory status (>3 mg/L hs-CRP), SBP [Adj R2 = 0.49 ( β = 0.99, 0.45, 1.44), p ≤ 0.01] and pulse pressure [Adj R2 = 0.61 ( β = 0.0.34, 0.88), p ≤ 0.01] respectively, predicted ECG LVH in African but not in Caucasian men. Conclusions Hyperdynamic blood pressure and inflammation acted in tandem as possible promoting factors to structural wall abnormalities in African men.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2013.03.075