More Black vs White Patients Have Risk Factors for LV Hypertrophy

Cardiovascular (CV) risk factors and left ventricular mass index (LVMI) significantly differed between Black and White young adult female patients classified as being obese, according to data presented by investigators from The Heart Institute, Cincinnati Children’s Hospital Medical Center,¹ at the American Society for Preventive Cardiology’s Congress on CVD Prevention, held in Arlington, Texas, July 21-23.

“Our aim was to utilize an existing longitudinal data set of Black and White females to evaluate racial differences in the impact of CV risk factors on adiposity measured by different modalities and to determine the contribution of adiposity to increased LVM,” the study investigators wrote.

Cardiovascular data

There were 553 patients in their overall cohort, of whom 305 were Black and 248 White. Data were from the National Growth and Health Study and encompassed demographics, medical history, laboratory findings, anthropometrics (an individual’s physical measures of size, form, and functional capacity²), and imaging, which itself included dual energy x-ray absorptiometry (DEXA), MRI (abdominal subcutaneous and visceral fat), and echocardiogram (ECG). The bookends used were age at first DEXA scan (20-21 years) and age at final ECG (24-27 years).

Of the 18 CV risk variables examined at baseline, with a P value of ≤ .05 considered statistically significant, the following were increased in the Black patient vs the White patient cohort:

• Weight: 83.1 (23.0) vs 71.4 (19.9) kg
• Body mass index: 30.8 (8.2) vs 26.3 (7.1) kg/m²
• Waist circumference: 87.5 (15.6) vs 80.0 (14.1) cm
• Hip circumference: 112.3 (15.2) vs 105.2 (13.7) cm
• Insulin: 13.1 (8.6) vs 10.6 (10.2) microIU/mL
• Glucose: 88.4 (35.3) vs 82.0 (11.2) mg/dL
• Systolic blood pressure: 109.4 (10.2) vs 105.3 (9.3) mm Hg
• Diastolic blood pressure: 68.4 (10.5) vs 66.5 (8.7) mm Hg
• Subcutaneous fat volume: 3.85 (2.44) vs 2.67 (2.10) L
• Total fat volume: 4.46 (2.80) vs 3.32 (2.67) L
• Total fat mass: 25.8 (15.2) vs 20.6 (11.2) kg
• Total lean mass: 46.0 (7.4) vs 42.9 (6.3) kg
• Total mass: 74.4 (20.8) vs 65.8 (16.5) kg
• Total percent fat mass: 32.3% (10.1%) vs 29.7% (7.8%)
• LVMI: 34.7 (9.1) vs 30.6 (8.9) g/m²

Only total cholesterol (180.2 [34.0] vs 170.0 [33.0] mg/dL), total triglycerides (109.7 [56.6] vs 86.3 [45.0] mg/dL), and high-density lipoprotein cholesterol (53.9 [14.5] vs 50.5 [12.5]) were higher among the White patients.

In particular, the investigators noted that the disparity in LVMI was considered statistically significant (P < .001) and that their findings overall demonstrate potential for significant racial differences in CV risk factors by young adulthood.

To start to close these CV risk factor disparity gaps, future studies need to examine how social determinants of health and various adiposities (eg, central vs peripheral, subcutaneous vs visceral), measured in different ways, contribute to the disparate outcomes, the authors concluded.

Potential limitations on these findings are that the study population comprised only female patients who were Black or White and that LVMI was measured only by ECG, “which is less accurate than cardiac MRI,” the authors wrote.

References

1. Sill J, Woo J, Urbina E. Racial differences in cardiovascular risk factors and the development of left ventricular hypertrophy. Presented at: ASPC Congress on CVD Prevention; July 21-23, 2023; Arlington, Texas. Poster 115.

2. Anthropometry. The National Institute for Occupational Safety and Health. Updated August 30, 2022. Accessed August 29, 2023. https://www.cdc.gov/niosh/topics/anthropometry/default.html#:~:text=Print-,Anthropometry,%2C%20form%2C%20and%20functional%20capacities