Antihypertensive medications and diastolic dysfunction progression in an African American population.

Abstract

There have been no studies examining the association between antihypertensive medications and progression of diastolic dysfunction. The purpose of this study is to determine whether there is an association between class of antihypertensive medication and diastolic dysfunction progression in an African American population. A retrospective cohort study of African American patients with at least two echocardiograms demonstrating diastolic dysfunction drawn from an echocardiogram database at an academic medical center. The main outcome measures were change in diastolic function grade as a function of time and association with hypertension medication classification. There were 96 African American patients in the database with 2 or more echocardiograms demonstrating diastolic dysfunction; representing 302 echocardiograms. The mean time between echocardiograms was 2.6 years. The mean age was 64.2 (±10.1) years, 78 % were women, and mean BMI 31.2 (±7.4) kg/m(2). The majority of subjects had Grade I diastolic dysfunction at their initial examination [N = 87 (90.6 %)]. Approximately 22.9 % (n = 22) of the study cohort demonstrated diastolic dysfunction progression. In multivariate analysis use of calcium channel blockers (CCB) was protective against diastolic dysfunction progression (OR for CCB users vs. non-users 0.28, 95 % confidence interval, 0.09-0.90, p < 0.05). These findings suggest that use of calcium channel blockers may have a protective effect against progression of diastolic dysfunction among African American patients. Further studies are required to confirm these findings and identify specific factors that can mediate disease progression among African American individuals with hypertension, who face substantial risk of complications such as diastolic heart failure.