Low Grade Inflammation and ECG Left Ventricular Hypertrophy in Urban African Males: The SABPA Study

BackgroundHypertension and vascular hyperresponsiveness have been associated with structural wall abnormalities in black Africans. Whether low grade inflammation would have an additive effect is uncertain. Therefore, a novel investigation aimed to assess whether inflammation and pressure overload would have an additive association with ECG left ventricular hypertrophy (LVH).MethodsWe included 75 African and 87 Caucasian males. Ambulatory blood pressure monitoring was done in the working week. A resting 12-lead ECG recording was used for the determination of LVH with the Cornell product formula. Fasting blood samples were obtained for high sensitivity C-reactive protein (hs-CRP) analyses after a controlled overnight stay. Men were stratified into low (≤3 mg/L) and high (>3 mg/L) hs-CRP groups.ResultsAfrican men revealed higher ambulatory blood pressure levels compared to Caucasian men independent of hs-CRP levels after adjustment for age, physical activity, cotinine, log γ-GT and body surface area. In forward stepwise linear regression analyses, SBP was positively associated with ECG LVH in all Africans. Considering low grade inflammatory status (>3 mg/L hs-CRP), SBP [Adj R2 = 0.49 (β = 0.99, 0.45, 1.44), p ≤ 0.01] and pulse pressure [Adj R2 = 0.61 (β = 0.0.34, 0.88), p ≤ 0.01] respectively, predicted ECG LVH in African but not in Caucasian men.ConclusionsHyperdynamic blood pressure and inflammation acted in tandem as possible promoting factors to structural wall abnormalities in African men.