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Racial Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood

Mendizabal, Brenda, M.D.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504794323476548

Abstract Details

2017, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Cross-sectional studies have demonstrated a relationship between cardiovascular (CV) risk factors and left ventricular mass (LVM) in adolescents. Few data exist relating the burden of those risk factors over the childhood and young adult years on LVM, a known risk factor for hard CV events later in life. Racial differences exist in the development of cardiovascular disease (CVD), with blacks being adversely affected. We sought to examine the relationship and racial differences between CV risk factors measured since age 10, and LVM/ht2.7 (LVMI) in adulthood in the NHLBI Growth and Health Study (NGHS), a longitudinal study examining the origins of racial differences in accumulation of adiposity and development of CV risk in girls. A total of 556 girls (mean age 10.0 years, 55.2% black, 45.8% white) had anthropometrics, blood pressure, and labs performed at up to 17 visits. LVMI was collected with 2-D guided echocardiographic imaging at a mean age of 26 years. Mean values at baseline and follow-up, and area under the curve (AUC) for CV risk factors, stratified by race, were examined by t-tests. General linear models were constructed to evaluate independent determinants of LVMI overall, and stratified by race. The initial full model contained race, body mass index (BMI), percent body fat by skinfold (PBF), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), low density lipoprotein cholesterol (LDL-C), triglyceride/high-density lipoprotein (TG/HDL) ratio, HOMA-IR (homeostasis model assessment of insulin resistance), and c-reactive protein (CRP). As seen previously, black girls had higher LVMI compared to whites. Blacks also had higher adiposity and insulin across time and lower TG/HDL ratio (all p-values < .0001). The major determinants of LVMI were race, BMI z-score AUC, SBP z-score AUC, PBF AUC, HR AUC and an interaction between race and HR (model R2 = 0.40, p-value < 0.0001). Stratifying by race, HR did not enter the model for blacks. The major determinants of LVMI in young adult females are adiposity and SBP. The contribution of HR to LVMI in whites may relate to previously noted higher sympathetic tone in obese whites. Efforts to prevent the development of obesity and hypertension in young girls are essential to reduce future hard CV events in adulthood.
Erin Haynes, Dr.P.H. (Committee Chair)
Phillip Khoury, M.S (Committee Member)
Elaine Urbina, M.D. (Committee Member)
25 p.
Surgery
left ventricular mass; race; obesity; blood pressure

Recommended Citations

Citations

  • Mendizabal, M.D., B. (2017). Racial Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504794323476548

    APA Style (7th edition)

  • Mendizabal, M.D., Brenda. Racial Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood. 2017. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504794323476548.

    MLA Style (8th edition)

  • Mendizabal, M.D., Brenda. "Racial Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood." Master's thesis, University of Cincinnati, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504794323476548

    Chicago Manual of Style (17th edition)

ucin1504794323476548
384
© 2017, some rights reserved.Creative Commons License Racial Differences in the Influence of Risk Factors in Childhood on Left Ventricular Mass in Young Adulthood by Brenda Mendizabal M.D. is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by University of Cincinnati and OhioLINK.