Likelihood Of Left Ventricular Hypertrophy Research Articles

Effects of cocaine and/or heroin use on resting cardiovascular function

BackgroundRegular cocaine and/or heroin use is associated with major health risks, especially cardiovascular disease, but confounded by other factors. We examined effects of chronic (years regular use) and recent (past-month) cocaine and heroin use, controlling for other factors, on resting cardiovascular function. MethodsIn a sample of 292 cocaine and/or heroin users, we assessed demographics, body mass index (BMI), substance use history, electrocardiogram, heart rate (HR) and blood pressure (BP). Three-block (1: demographics, BMI; 2: tobacco, alcohol, cannabis; 3: cocaine, heroin) regression analyses were conducted to predict cardiovascular measures. ResultsHigher BMI predicted increased systolic and diastolic BP (as did older age), increased supine HR, and longer QRS duration, QTc interval, PR interval, and P-wave duration. Past-month cannabis-use days predicted higher systolic BP, lower supine HR, and greater likelihood of early repolarization and ST elevation; average daily cannabis use predicted shorter QTc interval. Average daily alcohol use predicted higher diastolic BP, higher supine HR and lower likelihood of sinus bradycardia (HR < 60 bpm). Past-month tobacco-use days predicted shorter QTc interval and lower lower likelihood of profound bradycardia (HR < 50 bpm). Past-month heroin-use days predicted lower seated HR, greater likelihood of sinus bradycardia and lower likelihood of left ventricular hypertrophy. More years of regular cocaine use and past-month cocaine-use days predicted longer QTc interval. ConclusionsCocaine and heroin use incrementally predicted modest variance in resting bradycardia and QTc interval. Clinicians should first consider demographics and recent use of tobacco, alcohol and cannabis before assuming cocaine and heroin affect these measures.

FUSTER-BEWAT SCORE VERSUS IDEAL CARDIOVASCULAR HEALTH SCORE TO PREDICT LEFT VENTRICULAR HYPERTROPHY: DATA FROM CHINA PEACE MILLIONS PERSONS PROJECT

Abstract Objective: The Fuster-BEWAT Score (FBS) has been recently developed for use in lifestyle-based cardiovascular disease prevention, presenting similar accuracy in predicting subclinical atherosclerosis with ideal cardiovascular health score (ICHS), but it is unclear whether these scores exhibit comparable predictive values for detection of left ventricular hypertrophy (LVH). We evaluated the effectiveness of ICHS and FBS in assessing the presence of LVH among Chinese population. Design and method: A total of 3,521 participants aged 35 to 75 years with echocardiography screening in Guangdong were enrolled in the China PEACE (Patient centered Evaluative Assessment of Cardiac Events) Millions Persons Project. Subjects were grouped into three categories according to the number of favorable ICHS or FBS: ideal, intermediate, and poor. Left ventricular mass index (LVMI) was assessed by left ventricular mass divided by body surface area. LVH was defined as LVMI &gt; = 115 g/m2 in male and LVMI &gt; = 95 g/m2 in female. Results: In this study, poor ICHS accounts for 14.3% of all participants, intermediate ICHS 78.2%, and ideal ICHS 7.6%; poor FBS accounts for 4.4% of all participants, intermediate FBS 65.4%, and ideal FBS 30.2%. With poor ICHS as references, those with intermediate and ideal ICHS showed substantially lower adjusted odds of having LVH (odds ratio (OR) [95% confidence interval (CI)]: 0.643 [0.417, 0.991] and 0.346 [0.219, 0.547], respectively, with a p-value for trend &lt; 0.001). Compared with participants with poor FBS, intermediate and ideal FBS were negatively associated with the likelihood of LVH (OR [95%CI]: 0.638 [0.512, 0.796] and 0.316 [0.211, 0.473], respectively, with a p-value for trend &lt; 0.001). The Receiver Operating Characteristic Curve (ROC) indicated identical discriminating accuracy of ICHS (Area Under Curve (AUC): 0.696) and FBS (AUC: 0.702) with DeLong's test p-value 0.172 in identifying LVH. Conclusions: Both ICHS and FBS predict the presence and extent of subclinical atherosclerosis with similar accuracy, highlighting the value of the FBS as a simpler and more affordable score for evaluating the risk of LVH.

Correlates of Isolated Nocturnal Hypertension and Target Organ Damage in a Population-Based Cohort of African Americans: The Jackson Heart Study

African Americans have higher rates of nocturnal hypertension and less nocturnal blood pressure (BP) dipping compared with whites. Although nocturnal hypertension is associated with increased cardiovascular morbidity and mortality, its clinical significance among those with normal daytime BP is unclear. This paper reports the prevalence and correlates of isolated nocturnal hypertension (INH) in a population-based cohort of African Americans enrolled in the Jackson Heart Study (JHS). The study sample included 425 untreated, normotensive and hypertensive JHS participants who underwent 24-hour ambulatory BP monitoring (ABPM), echocardiography, and 24-hour urine collection. Multiple logistic regression and 1-way analysis of variance models were used to test the hypothesis that those with INH have worse target organ damage reflected by greater left ventricular (LV) mass and proteinuria compared with normotensive participants. Based on 24-hour ABP profiles, 19.1% of participants had INH. In age and sex-adjusted models, participants with INH had greater LV mass compared with those who were normotensive (P = 0.02), as well as about 3 times the odds of LV hypertrophy and proteinuria (Ps < 0.10). However, multivariable adjustment reduced the magnitude and statistical significance of each of these differences. INH was associated with increased LV mass compared with normo tension in a population-based cohort of African Americans enrolled in the JHS. There were trends toward a greater likelihood of LV hyper trophy and proteinuria among participants with INH vs. those who were normotensive. The clinical significance of the noted target organ damage should be explored in this population.