Yan Hou1, Kathleen A Ryan2, Carolyn A Cronin3, Elizabeth M Aradine1, John W Cole3, Seemant Chaturvedi3, Marcella A Wozniak3, Prachi Mehndiratta1, Michael S Phipps3, Karen L Yarbrough1, Mohammad Yousaf1, Steven J Kittner4. 1. Department of Neurology, University of Maryland School of Medicine, 655 West Baltimore Street- Rm12-006, Baltimore, MD 21201-1559, United States. 2. VA Maryland Health Care System, Baltimore, MD, United States; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States. 3. Department of Neurology, University of Maryland School of Medicine, 655 West Baltimore Street- Rm12-006, Baltimore, MD 21201-1559, United States; VA Maryland Health Care System, Baltimore, MD, United States. 4. Department of Neurology, University of Maryland School of Medicine, 655 West Baltimore Street- Rm12-006, Baltimore, MD 21201-1559, United States; VA Maryland Health Care System, Baltimore, MD, United States. Electronic address: SKittner@umaryland.edu.
Abstract
OBJECTIVES: Few studies have addressed Black-White differences in left ventricular hypertrophy (LVH) in young stroke patients without a history of hypertension. METHODS: A case-only cross-sectional analysis performed in 2019 of data from the Stroke Prevention in Young Adults Study, a population-based case-control study of ischemic stroke patients ages 15-49. The main outcomes were hypertension indicators at the time of stroke hospitalization: self-reported history of hypertension, LVH by echocardiography (Echo-LVH) and LVH by electrocardiogram (ECG-LVH). The prevalence of Echo-LVH was further determined in those with and without a history of hypertension. Adjusted odds ratios and 95% confidence intervals comparing blacks and whites were calculated by logistic regression. RESULTS: The study population included 1028 early-onset ischemic stroke patients, 48% Black cases, 54% men, median age 43 years (interquartile range, 38-46 years). Overall, the prevalence of hypertension history, Echo-LVH and ECG-LVH were 41.3%, 34.1% and 17.5%, respectively. Each of the hypertension indicators were more frequent in men than in women and in Black cases than in White cases. Black patients without a history of hypertension had higher rates of Echo-LVH than their white counterparts, 40.3% vs 27.7% (age and obesity adjusted OR 1.8; 95% CI 1.02-3.4) among men and 20.9% vs 7.6% (adjusted OR 2.7; 95% CI 1.2-6.2) among women. CONCLUSIONS: LVH was common in young patients with ischemic stroke, regardless of self-reported history of hypertension. These findings emphasize the need for earlier screening and more effective treatment of hypertension in young adults, particularly in the Black population. Published by Elsevier Inc.
OBJECTIVES: Few studies have addressed Black-White differences in left ventricular hypertrophy (LVH) in young stroke patients without a history of hypertension. METHODS: A case-only cross-sectional analysis performed in 2019 of data from the Stroke Prevention in Young Adults Study, a population-based case-control study of ischemic stroke patients ages 15-49. The main outcomes were hypertension indicators at the time of stroke hospitalization: self-reported history of hypertension, LVH by echocardiography (Echo-LVH) and LVH by electrocardiogram (ECG-LVH). The prevalence of Echo-LVH was further determined in those with and without a history of hypertension. Adjusted odds ratios and 95% confidence intervals comparing blacks and whites were calculated by logistic regression. RESULTS: The study population included 1028 early-onset ischemic stroke patients, 48% Black cases, 54% men, median age 43 years (interquartile range, 38-46 years). Overall, the prevalence of hypertension history, Echo-LVH and ECG-LVH were 41.3%, 34.1% and 17.5%, respectively. Each of the hypertension indicators were more frequent in men than in women and in Black cases than in White cases. Black patients without a history of hypertension had higher rates of Echo-LVH than their white counterparts, 40.3% vs 27.7% (age and obesity adjusted OR 1.8; 95% CI 1.02-3.4) among men and 20.9% vs 7.6% (adjusted OR 2.7; 95% CI 1.2-6.2) among women. CONCLUSIONS: LVH was common in young patients with ischemic stroke, regardless of self-reported history of hypertension. These findings emphasize the need for earlier screening and more effective treatment of hypertension in young adults, particularly in the Black population. Published by Elsevier Inc.
Entities:
Keywords:
Health disparities; Hypertension; Left ventricular hypertrophy; Stroke; Young adults
Authors: P M Rautaharju; L P Park; J S Gottdiener; D Siscovick; R Boineau; V Smith; N R Powe Journal: J Electrocardiol Date: 2000-07 Impact factor: 1.438
Authors: Jani Pirinen; Jukka Putaala; Aapo L Aro; Ida Surakka; Anita Haapaniemi; Markku Kaste; Elena Haapaniemi; Turgut Tatlisumak; Mika Lehto Journal: Int J Cardiol Date: 2015-06-29 Impact factor: 4.164
Authors: S MacMahon; R Peto; J Cutler; R Collins; P Sorlie; J Neaton; R Abbott; J Godwin; A Dyer; J Stamler Journal: Lancet Date: 1990-03-31 Impact factor: 79.321
Authors: Daniel T Lackland; Virginia J Howard; Mary Cushman; Suzanne Oparil; Brett Kissela; Monika M Safford; Dawn O Kleindorfer; Leslie A McClure; George Howard Journal: Circulation Date: 2020-10-05 Impact factor: 29.690
Authors: Karri Suvila; Elizabeth L McCabe; Joao A C Lima; Jenni Aittokallio; Yuichiro Yano; Susan Cheng; Teemu J Niiranen Journal: Am J Hypertens Date: 2020-07-18 Impact factor: 2.689