Black-white Differences in Left Ventricular Hypertrophy Rates Among Young Adults with Ischemic Stroke |
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| Institution: | 1. Department of Neurology, University of Maryland School of Medicine, 655 West Baltimore Street- Rm12-006, Baltimore, MD 21201-1559, United States;2. VA Maryland Health Care System, Baltimore, MD, United States;3. Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States;1. Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA;2. School of Medicine, Stony Brook University, Stony Brook, NY, USA;1. School of Industrial Technology, Advanced Institute of Industrial Technology, Tokyo Metropolitan Public University Corporation, Tokyo, Japan;2. Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan;4. Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan;5. Department of Community Mental Health & Low, National Center of Neurology and Psychiatry, Tokyo, Japan;6. Department of Dementia and Neuropsychology, Advanced Institute of Industrial Technology, Tokyo Metropolitan Public University Corporation, Tokyo, Japan;7. Department of Cognition and Behavioral Science, Nagoya University Graduate School of Medicine, Aichi, Japan;1. Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan;2. Department of Strokology, Stroke Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan;1. Duke University School of Medicine and Fuqua School of Business, DUMC - 3094, Durham, NC 27710, United States;2. Duke University Department of Biostatistics and Bioinformatics, United States;3. Hattiesburg Clinic, United States;4. Duke University Department of Radiology, United States;5. AegisCN LLC, United States;6. Duke University Departments of Anesthesiology and Neurology, Duke Clinical Research Institute and Aegis CN LLC, United States;7. Duke University Departments of Anesthesiology and Neurology and Duke Clinical Research Institute, United States;1. Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N14W5, Kita-Ku, Sapporo 060-8648, Japan;2. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, N14W5, Kita-Ku, Sapporo 060-8648, Japan;3. Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15W7, Kita-Ku, Sapporo 060-8648, Japan;4. The Division of Clinical Genetics, Hokkaido University Hospital, N14W5, Kita-Ku, Sapporo 060-8638, Japan;5. Department of Molecular Genetics, Wakayama Medical University, Kimiidera 811-1, Wakayama 641-8509, Japan |
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| Abstract: | ObjectivesFew studies have addressed Black-White differences in left ventricular hypertrophy (LVH) in young stroke patients without a history of hypertension.MethodsA case-only cross-sectional analysis performed in 2019 of data from the Stroke Prevention in Young Adults Study, a population-based case-control study of ischemic stroke patients ages 15–49. The main outcomes were hypertension indicators at the time of stroke hospitalization: self-reported history of hypertension, LVH by echocardiography (Echo-LVH) and LVH by electrocardiogram (ECG-LVH). The prevalence of Echo-LVH was further determined in those with and without a history of hypertension. Adjusted odds ratios and 95% confidence intervals comparing blacks and whites were calculated by logistic regression.ResultsThe study population included 1028 early-onset ischemic stroke patients, 48% Black cases, 54% men, median age 43 years (interquartile range, 38–46 years). Overall, the prevalence of hypertension history, Echo-LVH and ECG-LVH were 41.3%, 34.1% and 17.5%, respectively. Each of the hypertension indicators were more frequent in men than in women and in Black cases than in White cases. Black patients without a history of hypertension had higher rates of Echo-LVH than their white counterparts, 40.3% vs 27.7% (age and obesity adjusted OR 1.8; 95% CI 1.02–3.4) among men and 20.9% vs 7.6% (adjusted OR 2.7; 95% CI 1.2–6.2) among women.ConclusionsLVH was common in young patients with ischemic stroke, regardless of self-reported history of hypertension. These findings emphasize the need for earlier screening and more effective treatment of hypertension in young adults, particularly in the Black population. |
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