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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 . doi:10.1038/s41371-018-0064-z (In Press)
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Official URL: https://doi.org/10.1038/s41371-018-0064-z
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 | |||||||||
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| Subjects: | G Geography. Anthropology. Recreation > GN Anthropology R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Medicine > Warwick Medical School |
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| 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: | 1 May 2018 | |||||||||
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| Date of first compliant deposit: | 11 April 2018 | |||||||||
| DOI: | 10.1038/s41371-018-0064-z | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | In Press | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| RIOXX Funder/Project Grant: |
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