LEFT ventricular hypertrophy (LVH) is often benign and occurs without evidence of heart damage or stress, but in cases when it does occur together with signs of damage the course can be malignant and associated with higher risks of heart failure. In a recent study, the role of racial background as a risk factor for malignant LVH was elucidated.
Prof de Lemos, UT Southwestern Medical Center, Dallas, Texas, USA, stated that: “Malignant LVH is easily identifiable with widely used tests in the clinic, so now that we’ve found this association, we are hoping to identify patients with higher risk for heart failure earlier, when preventive interventions can have a greater impact on future risk.” Previous studies investigating malignant LVH did not include enough participants to decipher whether the observed differences contribute to an increased risk of heart failure for black individuals compared with white individuals. Therefore, data from three biracial cohort studies (Atherosclerosis Risk in Communities [ARIC] Study, the Dallas Heart Study, and the Multi-Ethnic Study of Atherosclerosis [MESA]) were pooled together for this investigation.
The three studies encompassed health data from >26,000 people living in the USA, and after excluding participants with cardiovascular or kidney disease and those who did not self-identify as white or black, data from 15,710 participants were included in the study. The median age of the study was 57 years, 56% were female, and 32% were black. Electrocardiography was applied to identify individuals with LVH and malignant LVH with the latter being defined as having abnormal blood marker levels attributable to injury or stress to the heart muscle. These characteristics were used to classify participants based on whether they had ECG-LVH and abnormal blood markers, and then determined how many of these participants had been hospitalised or died as a result of heart attack in the 10 years of follow-up.
Results revealed that those with malignant LVH were older, male, had diabetes, hypertension, and high blood pressure compared to those without LVH or LVH but normal blood tests. Furthermore, it was seen that the prevalence of malignant LVH was three times higher among black men and women compared to white participants. Over the 10-year study period, heart failure occurred in 512 patients (56% men, 39% black). The insights that the study has provided into why black men and women have higher rates of heart failure could help cardiologists identify those at higher risk and promote an earlier intervention for those who might benefit.