Abstract:
:Left ventricular hypertrophy (LVH) is more prevalent in black than white hypertensives, but this difference is greater when identified by electrocardiography (ECG) than by echocardiography. We evaluated the proposal that current ECG criteria for LVH are less specific, and therefore, less useful, in blacks than whites. In a retrospective cross-sectional study, 408 subjects (271 white, 137 black) referred to a hypertension clinic for assessment of hypertension underwent measurement of blood pressure, ECG voltages (Sokolow-Lyon and Cornell sex-specific), and echocardiographic left ventricular mass index (LVMI). Black subjects had greater ECG voltages than whites, even when closely matched for LVMI. In black subjects, current ECG criteria were twice as sensitive as in whites (Sokolow-Lyon: 44.9% v 22.5%, P = .003. Cornell: 30.4% v 15.7%, P = .03). They were less specific in blacks using the Sokolow-Lyon criteria (73.5% v 86.8%, P = .02) but this failed to reach significance using the Cornell criteria (83.8% v 91.8%, P = .07). When voltage criteria were adjusted to give matched sensitivities and specificities, respectively, differences in specificity and sensitivity were no longer apparent. Receiver operating characteristic curve analyses confirmed no significant differences in overall performance of either ECG criteria between blacks and whites. In conclusion, ECG detection of LVH is insensitive in both ethnic groups. Sensitivity is higher in blacks due to higher LVMI in those with LVH. Apparent differences in specificity are due to ethnic differences in ECG voltages that are unrelated to differences in LVMI. When these differences are taken into account, there are no overall differences in test accuracy. However, given the prognostic importance of the detection of LVH, currently accepted ECG voltage criteria for the detection of LVH remain of equal or greater value in black hypertensives compared with whites.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Chapman JN,Mayet J,Chang CL,Foale RA,Thom SA,Poulter NRdoi
10.1016/s0895-7061(99)00027-8subject
Has Abstractpub_date
1999-05-01 00:00:00pages
437-42issue
5eissn
0895-7061issn
1941-7225pii
S0895-7061(99)00027-8journal_volume
12pub_type
杂志文章abstract::Twenty-four hour blood pressure exposure and circadian blood pressure variability may be important predictors of hypertensive end-organ damage. Since sleep is a major determinant of circadian blood pressure decline, day/night blood pressure changes may be affected by sleep intervals. The current study compares 24-h bl...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/0895-7061(95)00196-V
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Endothelium-dependent vascular relaxation is impaired in various disease states including hypertension. METHODS:We investigated whether a single bolus dose of clofibrate could rapidly reverse saline-induced endothelial dysfunction, in vivo, in salt-loaded Sprague-Dawley (S-D) rats. S-D rats, 5 weeks of age,...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.04.005
更新日期:2006-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.12.009
更新日期:2007-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0895-7061(01)01310-3
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Physical activity (PA) has been associated with decreased left ventricular (LV) hypertrophy in previous studies. However, little is known about the relationship between PA and LV structure and factors which influence this relationship among African Americans. METHODS:We evaluated 1,300 African Americans wit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx044
更新日期:2017-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1038/ajh.2010.145
更新日期:2010-10-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.03.747
更新日期:2005-09-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/j.amjhyper.2003.08.008
更新日期:2004-01-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/hpu228
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journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1093/ajh/hpt011
更新日期:2013-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,meta分析
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更新日期:1994-08-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.08.001
更新日期:2007-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00144-2
更新日期:1999-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/6.3.92s
更新日期:1993-03-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.5.464
更新日期:1991-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(97)00496-2
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Most healthy people exhibit a decrease in systolic blood pressure (SBP) at night. A drop of <10% from mean daytime values, "non-dipping," is associated with kidney disease and cardiovascular events. We hypothesized that non-dipping would predict all-cause mortality. METHODS:Consecutive patients referred for...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.7
更新日期:2008-01-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00258-1
更新日期:1999-03-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.8.249
更新日期:1990-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.12.678s
更新日期:1991-12-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1038/ajh.2010.192
更新日期:2011-01-01 00:00:00
abstract::The effect of a surgical cure of hypercortisolism on hypertension in 54 patients with Cushing's syndrome was assessed. The correlation between preoperative duration of hypertension and posttreatment blood pressure was significant (P < .01). Restoration of normal cortisol was associated with blood pressure normalizatio...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/0895-7061(95)00299-5
更新日期:1996-01-01 00:00:00
abstract::We have previously reported that weight gain induced by high-fat diet (HFD) leads to an increase in mean arterial pressure (MAP, +14%) and heart rate (HR, +31%) in the adult rabbit. In the present study, we tested the hypothesis that an increased activity of the sympathetic nervous system may contribute to the develop...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00267-8
更新日期:2000-05-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/6.11.328s
更新日期:1993-11-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.4.386
更新日期:1988-10-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.2.124
更新日期:1988-04-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjhyper.2004.10.021
更新日期:2005-03-01 00:00:00