O-71 Sex differences and correlates of cardiac structure and function from the first population-based assessment of echocardiography in African Caribbeans
Author(s):
AL Kuipers, C Thomas, R Katz, DK Gupta, R Mallugari, V Wheeler, I Miljkovic
Year of Presentation:
2025
Objective: Abnormalities in cardiac structure and function
lead to increased risk of heart failure and other cardiovascular morbidity; yet, there are no population-based studies
of these in any Caribbean nation. Therefore, we performed
the first population-based assessment of cardiac structure
and function in African Caribbean men and women from
the Tobago Health Studies echocardiography on African
Caribbean men and women from the Tobago Health Studies
(N=936 recruited, N=623 complete).
Methods: Transthoracic echocardiography was performed by trained sonographers. Analyses focused on assessment of left ventricular (LV) ejection fraction (EF), LV mass index (LVMI), diastolic dysfunction, and LV geometry. Other data collected included questionnaires of health history and lifestyle, medications, and clinical measures such as height, weight, and blood pressures. Sex differences were tested using T-Tests or ANOVA, as appropriate. Risk factor associations were tested using linear or logistic regressions with adjustment for age and sex in all models, and significant independent CVD risk factors were identified through multiple regression methods, as appropriate.
Results: Participants were aged 50-96 years (mean 61 years) and were typically obese (mean BMI 31kg/m2 ) and hypertensive (79%), though these varied by sex (BMI 32kg/ m2 in women vs 26kg/m2 in men, P<0.001; 80% hypertension in women vs 71% in men, P=0.03). Overall, 13.5% had some diastolic dysfunction and 1.4% had LVEF<50% (11.2% had 50<=LVEF<60). 81% had cardiac structural remodeling (68% concentric remodeling, 13% left ventricular hypertrophy (LVH)). Women had 1% better LVEF and were less likely to have structural abnormalities than men (all P<0.05). Risk factors generally included age, sex, blood pressures, and anti-hypertension medication use; with alcohol use being independently associated with LVH only.
Conclusion: Both hypertension and obesity are highly prevalent conditions in Tobagonian adults. While cardiac remodeling was present in most participants, some also had LV diastolic dysfunction or reduced ejection fraction. Analyses of sex-differences highlight striking differences in cardiometabolic burden, though cardiac function was largely similar between sexes.