Impact of Diabetes and Hypertension on Left Ventricular Structure and Function: The Jackson Heart Study

Author:

Hamid Arsalan1ORCID,Yimer Wondwosen K.2,Oshunbade Adebamike A.3ORCID,Kamimura Daisuke4,Clark Donald13ORCID,Fox Ervin R.13,Min Yuan‐I1ORCID,Muntner Paul5ORCID,Shimbo Daichi6ORCID,Pandey Ambarish7ORCID,Shah Amil M.8ORCID,Mentz Robert J.9ORCID,Jones Daniel W.1ORCID,Bertoni Alain G.10,Hall John E.11ORCID,Correa Adolfo1ORCID,Butler Javed112ORCID,Hall Michael E.13ORCID

Affiliation:

1. Department of Medicine University of Mississippi Medical Center Jackson MS

2. Department of Data Science University of Mississippi Medical Center Jackson MS

3. Division of Cardiology, Department of Medicine University of Mississippi Medical Center Jackson MS

4. Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama Japan

5. School of Public Health University of Alabama at Birmingham Birmingham AL

6. Division of Cardiology, Department of Medicine Columbia University Medical Center New York NY

7. Division of Cardiology, Department of Medicine University of Texas Southwestern Medical Center Dallas TX

8. Division of Cardiology, Department of Medicine Harvard University Boston MA

9. Division of Cardiology, Department of Medicine Duke University Durham NC

10. Division of Public Health Sciences Wake Forest University Winston‐Salem NC

11. Department of Physiology and Biophysics University of Mississippi Medical Center Jackson MS

12. Baylor Scott and White Research Institute Dallas TX

Abstract

Background Diabetes and hypertension have been associated with adverse left ventricular (LV) remodeling. While they often occur concurrently, their individual effects are understudied. We aimed to assess the independent effects of diabetes and hypertension on LV remodeling in Black adults. Methods and Results The JHS (Jackson Heart Study) participants (n=4143 Black adults) with echocardiographic measures from baseline exam were stratified into 4 groups: neither diabetes nor hypertension (n=1643), only diabetes (n=152), only hypertension (n=1669), or both diabetes and hypertension (n=679). Echocardiographic measures of LV structure and function among these groups were evaluated by multivariable regression adjusting for covariates. Mean age of the participants was 52±1 years, and 63.7% were women. LV mass index was not different in participants with only diabetes compared with participants with neither diabetes nor hypertension ( P =0.8). LV mass index was 7.9% (6.0 g/m 2 ) higher in participants with only hypertension and 10.8% (8.1 g/m 2 ) higher in participants with both diabetes and hypertension compared with those with neither ( P <0.001). LV wall thickness (relative, posterior, and septal) and brain natriuretic peptide levels in participants with only diabetes were not significantly higher than participants with neither ( P >0.05). However, participants with both diabetes and hypertension demonstrated higher LV wall thickness and brain natriuretic peptide levels than participants with neither ( P <0.05). Conclusions In this cross‐sectional analysis, diabetes was not associated with altered LV structure or function in Black adults unless participants also had hypertension. Our findings suggest hypertension is the main contributor to cardiac structural and functional changes in Black adults with diabetes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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