Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter
  • Published:

Sex disparity in left ventricular hypertrophy in South Asians with hypertension: influence of central obesity and high blood pressure

Journal of Human Hypertension volume 37, pages 327–329 (2023)Cite this article

Subjects

Abstract

Women have been reported to be at greater risk of left ventricular hypertrophy (LVH) than men in South Asia, but whether the sex disparity is affected by central obesity and blood pressure has not been well studied. We examined prospectively the interaction of sex with waist circumference and systolic blood pressure at baseline on LVH measured after a median of 8-year follow-up among 539 individuals with hypertension in Karachi, Pakistan, and found that the risk of LVH for women vs men increased with higher baseline waist circumference and systolic blood pressure. Our results underscore the urgency for public health programs to prevent obesity and control hypertension in women in South Asia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Interaction of sex with baseline waist circumference and systolic blood pressure (SBP) on left ventricular hypertrophy (LVH).

Similar content being viewed by others

References

  1. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med. 1990;322:1561–6.

    Article  CAS  PubMed  Google Scholar 

  2. Lieb W, Xanthakis V, Sullivan LM, Aragam J, Pencina MJ, Larson MG, et al. Longitudinal tracking of left ventricular mass over the adult life course: clinical correlates of short- and long-term change in the framingham offspring study. Circulation. 2009;119:3085–92.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Misra A, Tandon N, Ebrahim S, Sattar N, Alam D, Shrivastava U, et al. Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. BMJ. 2017;357:j1420.

    Article  PubMed  Google Scholar 

  4. Jafary FH, Jafar TH. Disproportionately high risk of left ventricular hypertrophy in indo‐asian women: a call for more studies. Echocardiography. 2008;25:812–9.

    Article  PubMed  Google Scholar 

  5. Jafar TH, Hatcher J, Poulter N, Islam M, Hashmi S, Qadri Z, et al. Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial. Ann Intern Med. 2009;151:593–601.

    Article  PubMed  Google Scholar 

  6. Feng L, Khan AH, Jehan I, Allen J, Jafar TH. Albuminuria and kidney function as prognostic marker of left ventricular mass among South Asians with hypertension. J Am Soc Hypertens. 2017;11:811–22.e2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Jessani S, Levey AS, Bux R, Inker LA, Islam M, Chaturvedi N, et al. Estimation of GFR in South Asians: a study from the general population in Pakistan. Am J kidney Dis. 2014;63:49–58.

    Article  PubMed  Google Scholar 

  8. Writing Committee M, Quiñones MA, Douglas PS, Foster E, Gorcsan Iii J, Lewis JF, et al. American college of cardiology/American heart association clinical competence statement on echocardiography: a report of the American college of cardiology/American heart association/American college of physicians—American society of internal medicine task force on clinical competence. Circulation. 2003;107:1068–89.

    Article  Google Scholar 

  9. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–71.

    Article  PubMed  Google Scholar 

  10. Cai A, Liu L, Zhou D, Tang S, Zhou Y, Feng Y. Influences of achieved SBP on age and sex-related left ventricular structural alteration in community hypertensive populations. J Hypertens. 2022;40:1170–8.

    Article  CAS  PubMed  Google Scholar 

  11. Hayward CS, Kelly RP. Gender-related differences in the central arterial pressure waveform. J Am Coll Cardiol. 1997;30:1863–71.

    Article  CAS  PubMed  Google Scholar 

  12. Scantlebury DC, Borlaug BA. Why are women more likely than men to develop heart failure with preserved ejection fraction? Curr Opin Cardiol. 2011;26:562–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all members of the COBRA operational team including coordinators, data manager, field supervisors, data collectors, and other support staff for their hard work. The authors also thank the sonographers (Ms. Sundus Javed and Mr. Cyrus Tariq Gill) and the trial participants for their cooperation.

Funding

The study was supported by a research award (093382/Z/10/Z) from Wellcome Trust, UK. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore

    Liang Feng & Tazeen H. Jafar

  2. Section of Cardiology, Department of Medicine, Aga Khan University, Karachi, Pakistan

    Aamir Hameed Khan

  3. Department of Community Health Science, Aga Khan University, Karachi, Pakistan

    Imtiaz Jehan

  4. Department of Medicine, Aga Khan University, Karachi, Pakistan

    Zainab Samad

  5. Duke Global Health Institute, Duke University, Durham, NC, USA

    Tazeen H. Jafar

Authors
  1. Liang Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aamir Hameed Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Imtiaz Jehan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zainab Samad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tazeen H. Jafar
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study concept and design were performed by THJ. Literature review and statistical analysis were performed by FL. Drafting of the manuscript was done by FL and THJ. Acquisition of data was done by IJ, AHK, and THJ. All authors were responsible for analysis and interpretation of data, and critical revision of the manuscript for important intellectual content.

Corresponding author

Correspondence to Tazeen H. Jafar.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Feng, L., Khan, A.H., Jehan, I. et al. Sex disparity in left ventricular hypertrophy in South Asians with hypertension: influence of central obesity and high blood pressure. J Hum Hypertens 37, 327–329 (2023). https://doi.org/10.1038/s41371-023-00814-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-023-00814-0

This article is cited by

Search

Advanced search

Quick links