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Predictors of diastolic dysfunction in ethnic groups : observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES)

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Shantisila, A., Shantisila, E., Gill, Paramjit and Lip, Gregory Y. H. (2018) Predictors of diastolic dysfunction in ethnic groups : observations from the Hypertensive Cohort of The Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES). Journal of Human Hypertension, 32 . pp. 477-486. doi:10.1038/s41371-018-0064-z ISSN 1476-5527.

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Official URL: https://doi.org/10.1038/s41371-018-0064-z

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Abstract

The study aimed to establish a relationship of ethnicity to diastolic dysfunction in subjects of African-Caribbean and South Asian origins and the impact of diastolic dysfunction and ethnicity on all-cause and cardiovascular mortality. Hypertensive subjects with ejection fraction ≥55% and no history of ischaemic heart disease/valve pathology (n  =  1546, 830 South Asians and 716 African-Caribbeans) were identified from the Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES). Diastolic function and cardiac remodelling were measured by echocardiography. African-Caribbean ethnicity was associated with lower prevalence of having diastolic dysfunction (odds ratio 0.67, 95% confidence interval 0.51–0.87, p  =  0.003) and increased left ventricular filling pressure (odds ratio 0.48, 95% confidence interval 0.34–0.69, p <  0.001) as well as lower left atrial index (p  <  0.001). This was the case despite the fact that African-Caribbean ethnicity was independently associated with higher left ventricular mass index (p   < 0.001). Ninety-two deaths (6%) occurred during 68  ±  21 months follow-up. On Cox regression analysis, South Asian ethnicity (p  =  0.024) was predictive of all-cause death before adjustment for parameters of diastolic dysfunction, but it was no longer predictive of death after accounting for these variables. South Asian ethnicity is independently associated with worse parameters of diastolic function in hypertension, despite African-Caribbeans having more prominent hypertrophy.

Item Type: Journal Article
Subjects: G Geography. Anthropology. Recreation > GN Anthropology
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Cardiovascular system -- Diseases -- Research -- West Midlands (England), Ethnicity
Journal or Publication Title: Journal of Human Hypertension
Publisher: Nature Publishing Group
ISSN: 1476-5527
Official Date: July 2018
Dates:
DateEvent
July 2018Published
1 May 2018Available
6 April 2018Accepted
Volume: 32
Page Range: pp. 477-486
DOI: 10.1038/s41371-018-0064-z
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 11 April 2018
Date of first compliant Open Access: 1 November 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
PG/05/036British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
UNSPECIFIEDHeart of Birmingham Teaching Primary Care Trusthttp://viaf.org/viaf/173968572
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