CONGESTIVE-HEART-FAILURE, CORONARY EVENTS AND ATHEROTHROMBOTIC BRAIN INFARCTION IN ELDERLY BLACKS AND WHITES WITH SYSTEMIC HYPERTENSION AND WITH AND WITHOUT ECHOCARDIOGRAPHIC AND ELECTROCARDIOGRAPHIC EVIDENCE OF LEFT-VENTRICULAR HYPERTROPHY

Hypertension was presented in 50% of 196 blacks and in 36% of 382 whites (p < 0.001). A prospective study of 84 elderly blacks (70% women) and 326 elderly whites (73% women) with hypertension correlated echocardiographic and electrocardiographic left ventricular (LV) hypertrophy with incidences of congestive heart failure (CHF), coronary events and atherothrombotic brain infarction (ABI). Echocardiographic LV hypertrophy (p < 0.02) and concentric LV hypertrophy (p < 0.001) were more prevalent in hypertensive blacks than in hypertensive whites. Hypertensive blacks were younger (78 +/- 9 years) than hypertensive whites (82 +/- 7 years) (p < 0.001). Other coronary risk factors were similar, except for higher serum triglycerides in whites than in blacks (p < 0.02). Follow-up was 37 +/- 18 months in blacks and 43 +/- 18 months in whites (p < 0.01). Incidences of CHF and coronary events were not significantly different in blacks and whites. ABI incidence was 38% in blacks and 21% in whites (p < 0.005). Multiple logistic regression analysis showed that prior CHF (p = 0.000), concentric LV hypertrophy (p = 0.018) and echocardiographic LV hypertrophy (p = 0.022) were independent risk factors for CHF. Echocardiographic LV hypertrophy (p = 0.001), serum total cholesterol (p = 0.002), concentric LV hypertrophy (p = 0.005) and prior coronary artery disease (p = 0.042) were independent risk factors for coronary events. Prior ABI (p = 0.001), echocardiographic LY hypertrophy (p = 0.001) and electrocardiographic LV hypertrophy (p = 0.034) were independent risk factors for ABI.