Low grade inflammation and ECG left ventricular hypertrophy in urban African males: the SABPA study

Abstract

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 R(2)=0.49 (β=0.99, 0.45, 1.44), p≤0.01] and pulse pressure [Adj R(2)=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.