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LVH: Another Good Reason African Americans Should Watch Their Blood Pressure

Hypertension disproportionately affects African Americans at a higher rate, and hypertension is a risk factor for left ventricular hypertrophy.
Hypertension disproportionately affects African Americans at a higher rate, and hypertension is a risk factor for left ventricular hypertrophy.

Left ventricular hypertrophy, a thickening in the main pump chamber of the heart, strikes African Americans at a higher rate.

Even though heart failure sounds as if the heart has completely stopped working and nothing can be done, the term actually means it can’t pump enough blood and oxygen to support your body’s needs. It's a condition that occurs over time, and recent research points to LVH as a possible reason.

KERA’s Vital Signs host Sam Baker talked about this in March 2020 with Dr. Alana Lewis, a former cardiology fellow with Parkland Hospital System and UT Southwestern Medical Center, and now a cardiologist with Northwestern Medicine in Illinois. Dr. Lewis took part in the research.

Credit Shutterstock

About Left Ventricular Hypertrophy (LVH): The left ventricle is the main pump chamber of the heart. It's on the bottom of the heart on the left side, and that's what essentially pumps blood out through the aorta, which is the big blood vessel in your body and supplies blood to your organs.

Hypertrophy means enlargement or thickening. What can happen over time is the left ventricle muscle can become thickened and the mass can increase.

What causes LVH: The most typical thing is longstanding hypertension. So having high blood pressure for long periods of time can put some stress and strain on the heart and can lead to left ventricular hypertrophy.

Does LVH directly cause heart disease? In most cases it's a benign condition, kind of a marker of having high blood pressure. But in our study, we determined that in some cases it can have a more malignant kind of phenotype, and it can be a step on a pathway to developing heart failure down the road.

Why LVH strikes African Americans at a higher rate: It comes down to the risk factors. So hypertension, unfortunately, disproportionally affects African-Americans. This can be for a number of reasons:

  • It can run in families, so really important you get checked for that.
  • It can be very asymptomatic, so people might not know that they have hypertension. It can go uncontrolled for a very long time.
  • It can be related to lifestyle, diet, weight and other factors.

High blood pressure can put more stress and more strain on the heart. That's what causes it to become thickened.
How LVH is detected: A number of tests. Some of them are as simple as doing a electrocardiogram or an EKG. Other ways are a little bit more time intensive, like a heart ultrasound, echocardiogram or a more advanced study, like a cardiac MRI.

Symptoms: LVH itself is asymptomatic. There's not anything specific that you might necessarily feel. As far as symptoms of heart failure:

  • Shortness of breath
  • Gaining more weight than usual
  • Swelling in your legs or ankles
  • Difficulty breathing at night

Best way to prevent LVH? Blood pressure control:

  • Limit your salt intake
  • Exercise
  • Reduce your alcohol intake
  • If those lifestyle measures aren't reaching your target, your doctor may need to prescribe medication.


Heart failure in African Americans: Disparities can be overcome (PDF)
Heart Disease and African Americans
Left ventricular hypertrophy

Interview highlights have been edited for clarity and brevity.

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.