Published Online
on January 20, 2005

A more recent version of this article appeared on March 1, 2005

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Submitted on November 3, 2004
Accepted on November 10, 2004

Left Ventricular Mass Indexed to Height and Prevalent MRI Cerebrovascular Disease in an African American Cohort. The Atherosclerotic Risk in Communities Study

Ervin R. Fox MD, MPH^*; Herman A. Taylor Jr MD, MPH; Emelia J. Benjamin MD, ScM; Jingzhong Ding PhD; Philip R. Liebson MD; Donna Arnett PhD; Ernest M. Quin MD; and Thomas N. Skelton MD

From the NHLBI Jackson Heart Study (E.R.F., H.A.T., T.N.S.), Mississippi; the University of Mississippi Medical Center (E.R.F., H.A.T., E.M.Q., T.N.S.), Jackson; the NHLBI FHS (E.J.B.), Massachusetts; Boston University School of Medicine (E.J.B.), Massachusetts; John Hopkins School of Public Health (J.D.), Baltimore, Md; Rush University Medical Center (P.R.L.), Chicago, Ill; and the University of Minnesota (D.A.), Minneapolis, Minn.

^* To whom correspondence should be addressed. E-mail: efox{at}medicine.umsmed.edu.

Background and Purpose--Previous studies have demonstrated that echocardiographic left ventricular mass (LVM) is an independent risk factor for stroke in whites. Despite the greater burden of stroke, the echocardiographic predictors of stroke in African Americans remain poorly understood.

Methods--This investigation is a retrospective analysis of prospectively collected data from the Jackson, Miss (all African American), cohort of the Atherosclerotic Risk in the Communities study. Between 1993 and 1995, 2445 participants received an echocardiogram, and a random subset (n=778) received cerebral MRI evaluating presence of infarcts or white matter disease (WMD; >3 on a scale of 0 to 9). Compared with the entire Jackson cohort, the random subset was older, had a lower body mass index (BMI), and a higher systolic blood pressure (SBP). Logistic regression models examined the relations of LVM indexed by height (LVM/height) to MRI findings adjusted for age, gender, BMI, SBP, hypertensive medications, diabetes, total/high-density lipoprotein cholesterol, smoking status, and history of myocardial infarction.

Results--The 667 participants (63% women; 62±4 years of age) had a high prevalence of hypertension (68%), obesity (46%), echocardiographic left ventricular hypertrophy (49%), MRI stroke (n=133), and WMD (n=92). Adjusted LVM/height was significantly associated with prevalent MRI stroke (odds ratio [OR], 1.3; 95% CI, 1.1 to 1.7; P=0.02) and WMD (OR, 1.5; 95% CI, 1.1 to 1.9; P=0.006; OR expressed per 1 SD LVM/height, 45 g/m).

Conclusion--In this randomized subset of a population-based cohort of African American adults, LVM/height was related to MRI evidence of prevalent cerebrovascular disease. The current study supports the hypothesis that LVM/height is an important risk factor for stroke in multiple ethnicities.

Key words: African American • cerebrovascular disorders • echocardiography • magnetic resonance imaging

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