W Indian Med J
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Comparative Study
Echocardiographic findings in a contemporary Afro-Caribbean Population referred for evaluation of unexplained syncope.
Echocardiographic findings were reviewed for 106 patients (mean age 41.3 +/- 23.0 years, range 3 to 90 years, 61% female) referred for evaluation of unexplained syncope. Abnormal echocardiographic findings were seen in 36/106 (34%) patients, of which 12/106 (11%) may have an abnormality that contributed to symptoms. Abnormal echocardiographic findings (64 vs 6%, p < 0.01) and those possibly causing syncope (22 vs 0%, p < 0.05) were significantly more likely in the oldest tercile of patients compared with the youngest. No patient less than 35 years old had a possibly diagnostic abnormality.
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Increased left ventricular mass (LVM) on echocardiogram is an independent risk factor for cardiac complications from hypertension. It is associated with a four-fold increase in untoward cardiac events when present. Data were reviewed for 100 treated hypertensive Afro-Caribbean patients, aged 29 to 65 years, recruited from village health clinics. ⋯ Drug treatment was reported in 90% (69% monotherapy, 27% > one drug, 4% > 2 drugs) and no drug was associated with significant difference in LVM compared to others. Only 15% of treated hypertensive patients had systolic blood pressure below 140 mmHg and 8% had diastolic blood pressure below 90 mmHg. The major determinant of increased LVM in this group of Afro-Caribbean hypertensive patients appears to be poorly controlled hypertension with obesity being a possible contributing factor