Shantsila, A., Shantsila, E., Gill, Paramjit and Lip, G. Y. H. (2017) Renal dysfunction and diastolic impairment among British ethnic minorities with hypertension : the Ethnic-Echocardiographic Heart of England Screening Study. Journal of Human Hypertension, 31 (3). pp. 206-211. doi:10.1038/jhh.2016.68 ISSN 0950-9240.

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Abstract

Renal dysfunction is frequently associated with left ventricular (LV) hypertrophy and diastolic dysfunction in hypertensive patients. Limited data exist on renal dysfunction and diastolic impairment among British ethnic minorities with hypertension. We studied associations between renal impairment and diastolic dysfunction in hypertensive subjects of African-Caribbean and South Asian origin. Five hundred and ten hypertensive subjects with ejection fraction greater than or equal to55% and with no history of ischaemic heart disease/valve pathology were included from the original population of the Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES). Diastolic function and cardiac remodelling were measured by echocardiography. LV hypertrophy was common and present in 62% of patients with normal estimated glomerular filtration rate (eGFR, >90 ml min−1 per 1.73 m2), 73% in those with eGFR 60–89 ml min−1 per 1.73 m2 and 87% with eGFR <60 ml min−1 per 1.73 m2. On both univariate and multivariable linear regression, reduced eGFR was associated with higher LV mass index (LVMI, P=0.01 and P=0.039, respectively). On multivariable analyses, increased LVMI (but not eGFR) was an independent predictor of echocardiographic parameters of diastolic dysfunction. Higher LVMI was an independent predictor of all-cause or cardiovascular death on multivariable analyses (both P=0.002), but not eGFR. LV hypertrophy is common in minority ethnic groups with hypertension, especially in the presence of renal dysfunction. Increased LVMI rather than renal impairment per se is a major determinant of diastolic dysfunction and increased risk of cardiovascular or all-cause death among hypertensive patients without end-stage renal failure.

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
Journal or Publication Title:	Journal of Human Hypertension
Publisher:	Nature Publishing Group
ISSN:	0950-9240
Official Date:	March 2017
Dates:	Date Event March 2017 Published
Volume:	31
Number:	3
Page Range:	pp. 206-211
DOI:	10.1038/jhh.2016.68
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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