Impact of Hypertension on Left Ventricular Geometry and Diastolic Function in Africa: Results from the Population-Based TAHES Cohort Study.

High blood pressure leads to morphologic changes and functional alterations of the myocardial structure. Transthoracic Echocardiography (TTE) is of high clinical interest to evaluate these alterations, using reference values proposed by the American Society of Echocardiography/European Association of Cardiovascular Imaging (ASE/EACVI), largely based on studies in Caucasian whites. We aimed to assess the impact of hypertension on echocardiographic parameters in a Sub-Saharan African community, using ethnic-specific reference values. This study is a part of TAHES, a population-based prospective cohort study initiated in 2015 in the district of Tanve, Republic of Benin. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or currently taking anti-hypertensive medications. All participants had a TTE. The patterns of diastolic dysfunction and left ventricular (LV) geometry were defined from 486 subjects of the cohort, free from cardiovascular disease, diabetes and hypertension. Among participants, 318 (65% women, median age 48 years) were hypertensive. Systolic blood pressure correlated significantly (p<0.0001) with LV mass (r=0.28), wall thickness (r=0.25), isovolumic relaxation time (r=0.27), E/A ratio (r=-0.35), lateral e' velocity (r=-0.41) and E/E'ratio (r=0.39). Ventricular geometry was normal in only 22% of hypertensive participants when using the ASE/EACVI reference values, vs. 69% with ethnic-specific reference ranges. The severity of hypertension was associated with ventricular geometry abnormalities. The prevalence of diastolic dysfunction was 14.5%(CI:10.6-18.4%), including relaxation impairment (9%) and pseudonormal pattern (6%). Thus, correct assessment of repercussions of hypertension on LV geometry in Black Africans requires ethnic-specific reference values.