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Premature cardiac aging in South Asian compared to Afro‐Caribbean subjects in a community‐based screening study
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Shantsila, Eduard, Shantsila, Alena, Gill, Paramjit and Lip, Gregory Y. H. (2016) Premature cardiac aging in South Asian compared to Afro‐Caribbean subjects in a community‐based screening study. Journal of the American Heart Association, 5 (11). e004110. doi:10.1161/JAHA.116.004110 ISSN 2047-9980.
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Official URL: http://dx.doi.org/10.1161/JAHA.116.004110
Abstract
Background People of South Asian (SAs) and African Caribbean (AC) origin have increased cardiovascular morbidity, but underlying mechanisms are poorly understood. Aging is the key predictor of deterioration in diastolic function, which can be assessed by echocardiography using E/e′ ratio as a surrogate of left ventricular (LV) filling pressure. The study aimed to assess a possibility of premature cardiac aging in SA and AC subjects.
Methods and Results We studied 4540 subjects: 2880 SA and 1660 AC subjects. All participants underwent detailed echocardiography, including LV ejection fraction, average septal‐lateral E/e′, and LV mass index (LVMI). When compared to ACs, SAs were younger, with lower mean LVMI, systolic blood pressure (BP), diastolic BP, and body mass index (BMI), as well as a lower prevalence of hypertension and smoking (P≤0.001 for all). In a multivariate linear regression model including age, sex, ethnicity, BP, heart rate, BMI, waist circumference, LVMI, history of smoking, hypertension, coronary artery disease, diabetes mellitus, medications, SA origin was independently associated with higher E/e′ (regression coefficient±standard error, −0.66±0.10; P<0.001, adjusted R2 for the model 0.21; P<0.001). Furthermore, SAs had significantly accelerated age‐dependent increase in E/e′ compared to ACs. On multivariable Cox regression analysis without adjustment for E/e′, SA ethnicity was independently predictive of mortality (P=0.04). After additional adjustment for E/e′, the ethnicity lost its significance value, whereas E/e′ was independently predictive of higher risk of death (P=0.008).
Conclusions Premature cardiac aging is evident in SAs and may contribute to high cardiovascular morbidity in this ethnic group, compared to ACs.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | 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 |
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| Journal or Publication Title: | Journal of the American Heart Association | ||||||
| Publisher: | American Heart Association | ||||||
| ISSN: | 2047-9980 | ||||||
| Official Date: | 10 November 2016 | ||||||
| Dates: |
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| Volume: | 5 | ||||||
| Number: | 11 | ||||||
| Article Number: | e004110 | ||||||
| DOI: | 10.1161/JAHA.116.004110 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) |
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