BACKGROUND: In the general population, blacks appear to have a higher risk of sudden cardiac death (SCD). OBJECTIVES: To determine whether black hypertensive patients have a higher SCD incidence. METHODS: The incidence of SCD was examined in 533 black and 8660 nonblack hypertensive patients with electrocardiographic left ventricular hypertrophy randomly assigned tolosartan- or atenolol-based treatment. RESULTS: During a mean follow-up of 4.8 ± 0.9 years, SCD occurred in 178 patients (1.9%); 5-year SCD incidence was significantly higher in black than in nonblack patients (3.9% vs 1.9%; P = .007). In univariate Cox analyses, black patients had a 97% higher risk of SCD (hazard ratio 1.97; 95% confidence interval 1.19-3.25; P = .015). In multivariate Cox analyses adjusting for randomized treatment, age, sex, body mass index, diabetes, history of heart failure, atrial fibrillation, myocardial infarction, ischemic heart disease, stroke, peripheral vascular disease, smoking, serum total and high-density lipoprotein cholesterol level, creatinine level, glucose level, and urine albumin/creatinine ratio and for incident myocardial infarction, in-treatment heart rate, QRS duration, diastolic and systolic pressure, Cornell voltage-duration product, and Sokolow-Lyon voltage left ventricular hypertrophy treated as time-varying covariates, black race remained associated with a 98% increased risk of SCD (hazard ratio 1.98; 95% confidence interval 1.12-3.59; P = .020). CONCLUSIONS:Black hypertensive patients are at increased risk of SCD. The higher risk of SCD in black patients persists after adjusting for the higher prevalence of risk factors in black patients, in-treatment blood pressure, and the established predictive value of in-treatment electrocardiographic left ventricular hypertrophy and heart rate for SCD in this population.
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BACKGROUND: In the general population, blacks appear to have a higher risk of sudden cardiac death (SCD). OBJECTIVES: To determine whether black hypertensivepatients have a higher SCD incidence. METHODS: The incidence of SCD was examined in 533 black and 8660 nonblack hypertensivepatients with electrocardiographic left ventricular hypertrophy randomly assigned to losartan- or atenolol-based treatment. RESULTS: During a mean follow-up of 4.8 ± 0.9 years, SCD occurred in 178 patients (1.9%); 5-year SCD incidence was significantly higher in black than in nonblack patients (3.9% vs 1.9%; P = .007). In univariate Cox analyses, black patients had a 97% higher risk of SCD (hazard ratio 1.97; 95% confidence interval 1.19-3.25; P = .015). In multivariate Cox analyses adjusting for randomized treatment, age, sex, body mass index, diabetes, history of heart failure, atrial fibrillation, myocardial infarction, ischemic heart disease, stroke, peripheral vascular disease, smoking, serum total and high-density lipoprotein cholesterol level, creatinine level, glucose level, and urine albumin/creatinine ratio and for incident myocardial infarction, in-treatment heart rate, QRS duration, diastolic and systolic pressure, Cornell voltage-duration product, and Sokolow-Lyon voltage left ventricular hypertrophy treated as time-varying covariates, black race remained associated with a 98% increased risk of SCD (hazard ratio 1.98; 95% confidence interval 1.12-3.59; P = .020). CONCLUSIONS: Black hypertensivepatients are at increased risk of SCD. The higher risk of SCD in black patients persists after adjusting for the higher prevalence of risk factors in black patients, in-treatment blood pressure, and the established predictive value of in-treatment electrocardiographic left ventricular hypertrophy and heart rate for SCD in this population.
Authors: Di Zhao; Wendy S Post; Elena Blasco-Colmenares; Alan Cheng; Yiyi Zhang; Rajat Deo; Roberto Pastor-Barriuso; Erin D Michos; Nona Sotoodehnia; Eliseo Guallar Journal: Circulation Date: 2019-04-02 Impact factor: 29.690
Authors: Yiyi Zhang; Robert Kennedy; Elena Blasco-Colmenares; Barbara Butcher; Sanaz Norgard; Zayd Eldadah; Timm Dickfeld; Kenneth A Ellenbogen; Joseph E Marine; Eliseo Guallar; Gordon F Tomaselli; Alan Cheng Journal: Heart Rhythm Date: 2014-05-02 Impact factor: 6.343
Authors: Joanna Ghobrial; Susan R Heckbert; Traci M Bartz; Gina Lovasi; Erin Wallace; Rozenn N Lemaitre; April F Mohanty; Thomas D Rea; David S Siscovick; Jean Yee; M Sue Lentz; Nona Sotoodehnia Journal: Heart Date: 2016-04-26 Impact factor: 5.994