Double product and end-organ damage in African and Caucasian men: the SABPA study
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Abstract
Background: Increasing urbanisation in sub-Saharan African countries is causing a rapid increase in cardiovascular
disease. Evidence suggests that Africans have higher blood pressures and a higher prevalence of
hypertension-related cardiovascular morbidity and mortality, compared to Caucasians. We investigated
double product (systolic blood pressure×heart rate), a substantial measure of cardiac workload, as a possible
cardiovascular risk factor in African and Caucasian men.
Material and methods: The study consisted of 101 urbanised African and 101 Caucasian male school teachers.
We measured 24 h ambulatory blood pressure and the carotid cross-sectional wall area, and determined left
ventricular hypertrophy electrocardiographically by means of the Cornell product. Urinary albumin and
creatinine were analysed to obtain the albumin-to-creatinine ratio.
Results: Africans had higher 24 h, daytime and nighttime systolic- and diastolic blood pressure, heart rate and
resultant double product compared to the Caucasians. In addition, markers of end-organ damage, albuminto-
creatinine ratio and left ventricular hypertrophy were higher in the Africans while cross-sectional wall
area did not differ. In Africans after single partial and multiple regression analysis, 24 h systolic blood
pressure, but not double product or heart rate, correlated positively with markers of end-organ damage
(cross-sectional wall area: β=0.398, P=0.005; left ventricular hypertrophy: β=0.455, Pb0.001; albuminto-
creatinine ratio: β=0.280, P=0.012). No associations were evident in Caucasian men.
Conclusions: Double product may not be a good marker of increased cardiovascular risk when compared to
systolic blood pressure in African and Caucasian men.
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Schultz, A.J. et al. 2013. Double product and end-organ damage in African and Caucasian men: the SABPA study. International journal of cardiology. 167:792-797. [http://www.journals.elsevier.com/international-journal-of-cardiology/]