Document Detail


Racial differences in incident heart failure during antihypertensive therapy.
MedLine Citation:
PMID:  21304095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Blacks have a higher prevalence of heart failure (HF) than nonblacks, possibly reflecting a greater burden of HF risk factors, including hypertension. Although HF incidence is significantly higher in blacks during long-term follow-up of young adults, the relationship of incident HF to race in hypertensive patients undergoing treatment is unclear.
METHODS AND RESULTS: Incident HF was evaluated in 497 black and 8199 nonblack hypertensive patients with no history of HF randomly assigned to losartan- or atenolol-based treatment. During 4.7±1.1 years mean follow-up, HF hospitalization occurred in 265 patients (3.0%); 5-year HF incidence was significantly greater in black than nonblack patients (7.0 versus 3.1%, P<0.001). In Cox multivariate analyses adjusting for randomized treatment, age, sex, the presence of the strain pattern on the baseline ECG, and other HF risk factors treated as standard covariates, and for incident myocardial infarction, in-treatment QRS duration, diastolic and systolic pressure, Cornell product, and Sokolow-Lyon voltage criteria for left ventricular hypertrophy (LVH) treated as time-varying covariates, black race remained associated with a 130% increased risk of developing new HF (hazard ratio 2.30, 95% confidence interval 1.24 to 4.28).
CONCLUSIONS: Incident HF is substantially more common among black than nonblack hypertensive patients. The increased risk of developing new HF in blacks persists after adjusting for the higher prevalence of HF risk factors in blacks, for treatment effects and in-treatment blood pressure, and for the known predictive value of the ECG strain pattern and in-treatment ECG LVH and QRS duration for incident HF in this population. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00338260.
Authors:
Peter M Okin; Sverre E Kjeldsen; Björn Dahlöf; Richard B Devereux
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-02-08
Journal Detail:
Title:  Circulation. Cardiovascular quality and outcomes     Volume:  4     ISSN:  1941-7705     ISO Abbreviation:  Circ Cardiovasc Qual Outcomes     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-16     Completed Date:  2011-07-28     Revised Date:  2011-10-27    
Medline Journal Info:
Nlm Unique ID:  101489148     Medline TA:  Circ Cardiovasc Qual Outcomes     Country:  United States    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Weill Cornell Medical College, New York, NY 10065, USA. pokin@med.cornell.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00338260
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MeSH Terms
Descriptor/Qualifier:
African Americans
Aged
Antihypertensive Agents / therapeutic use*
Asian Americans
Blood Pressure / physiology
Continental Population Groups
Electrocardiography
European Continental Ancestry Group
Female
Follow-Up Studies
Heart Failure / epidemiology*,  ethnology*,  physiopathology
Hispanic Americans
Humans
Hypertension / complications,  drug therapy*,  ethnology*
Hypertrophy, Left Ventricular / complications,  ultrasonography
Incidence
Kaplan-Meier Estimate
Losartan / therapeutic use*
Male
Middle Aged
Multivariate Analysis
Risk Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 114798-26-4/Losartan
Comments/Corrections
Comment In:
Circ Cardiovasc Qual Outcomes. 2011 Mar;4(2):143-5   [PMID:  21406669 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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