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Impact of Hypertension on Left Ventricular Geometry and Diastolic Fonction in Africa: Results from theCheckfor updatesPopulation-Based TAnve Health (TAHES) Cohort Study
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International audience. High blood pressure leads to morphologie changes and functional alterations of the myo- cardial structure. Transthoracic echocardiography is of great clinical interest to evaluate these alterations, using reference values proposed by the American Society of Echocardi- ography/European Association of Cardiovascular Imaging, largely based on studies in Caucasian Whites. We aimed to assess the impact of hypertension on échocardiographie parameters in a sub-Saharan African community, using ethnic-specific reference values.This study is part of the TAnve HEalth Study, a population-based prospective cohort study initiated in 2015 in the district of Tanve, Republic of Bénin. Hypertension was defined as systolic blood pressure >140 mm Hg and/or diastolic blood pressure >90 mm Hg and/or currently taking antihypertensive médications. Ail participants had a transtho racic echocardiography. The patterns of diastolic dysfunction and left ventricular (LV) geometry were defined from 486 subjects in the cohort, free from cardiovascular disease, diabètes, and hypertension. Of ail participants, 318 (65% women, médian âge 48 years) had hypertension. Systolic blood pressure correlated significantly (p <0.0001) with LV mass (r = 0.28), wall thickness (r = 0.25), isovolumic relaxation time (r = 0.27), E/A ratio (r = —0.35), latéral e' velocity (r= —0.41), and E/E' ratio (r = 0.39). Ventricular geometry was normal in only 22% of participants with hypertension when using the American Soci ety of Echocardiography/European Association of Cardiovascular Imaging reference val ues, versus 69% with ethnic-specific reference ranges. The severity of hypertension was associated with ventricular geometry abnormalities. The prevalence of diastolic dysfunc tion was 14.5% (confidence interval 10.6% to 18.4%), including relaxation impairment (9%) and pseudonormal pattern (6%). Thus, correct assessment of the repercussions of hypertension on LV geometry in Black Africans requires ethnic-specific reference val ues. © 2023 Elsevier Inc. Ail rights reserved. (Am J Cardiol 2024;211:275-281)
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