Ethnic variations in myocardial mass and left ventricular wall thickness among hypertension patients in Kazakhstan: an autopsy study

Rakhypbekov, Tolebay

Ethnic variations in myocardial mass and left ventricular wall thickness among hypertension patients in Kazakhstan: an autopsy study

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Akbayan Markabayeva, MD , Semey State Medical University, Semey, Kazakhstan

Aiman Kerimkulova, PhD , Semey State Medical University, Semey, Kazakhstan

Lyudmila Pivina, PhD , Semey State Medical University, Semey, Kazakhstan

Elena Beluhina, MD , Semey State Medical University, Semey, Kazakhstan

Z Ensegenova, MD , Semey State Medical University, Semey, Kazakhstan

Nurgul Yelissinova, PhD , Semey State Medical University, Semey, Kazakhstan

Gulya Yesbolatova, MD , Semey State Medical University, Semey, Kazakhstan

Ainur Yelissinova, PhD , Semey State Medical University, Semey, Kazakhstan

Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia

Tolebay Rakhypbekov, PhD , Semey State Medical University, Semey, Kazakhstan

INTRODUCTION: Kazakhstan has one of the highest mortality from cardiovascular diseases in the world while Russia has the highest. Autopsy studies are becoming more popular in the field of cardiovascular epidemiology, but no studies have been published from Kazakhstan. We studied the differences in myocardial mass and left ventricle wall thickness between ethnic Kazakhs and ethnic Russians who had hypertension.

METHODS: All patients with confirmed diagnosis of arterial hypertension who were autopsied Semey, Kazakhstan, in 1999-2012 comprised the study base. Data on ethnic background (Kazakh or Russian), age at death, gender, myocardial mass and left ventricle wall thickness were obtained from autopsy protocols at the Municipal Bureau of Forensic Medicine. Continuous data are presented as Means (M) and standard deviations (SD). Categorical data were compared using chi-squared tests. Differences in myocardial mass and left ventricle wall thickness between Kazakhs and Russians were studied by multiple linear regression.

RESULTS: Altogether, there were 365 ethnic Russians and 169 ethnic Kazakhs among the autopsied patients. Men comprised 53.2% among Russians and 71.8% among Kazakhs (p<0.001). Myocardial mass was greater among Russians for both men (M=582.3 g, SD=142.0 vs. M=536.7 g, SD=134.5, p=0.007) and women (M=543.0 g, SD=136.1 vs. M=478.2 g, SD=158.8, p=0.009). Left ventricle wall was thicker in both Russian men (M=1.73 cm, SD=0.52 vs. M=1.68 cm, SD=0.53, p=0.021), and women (M=1.68 cm, SD=0.54 vs. M=1.38 cm, SD=0.49, p=0.001) compared to Kazakhs in bivariate analysis. After adjustment for gender and age, the differences between Russians and Kazakhs were 44.9 g (95% CI: 18.6-77.1) for myocardial mass and 0.20 cm (95% CI: 0.09-0.31) for left ventricle wall thickness.

CONCLUSIONS: Ethnic Russians have greater myocardial mass and left ventricular wall thickness than ethnic Kazakhs even after adjustment for age and gender suggesting ethnic variations in remodeling patterns among hypertension patients. Limitations of the study and potential explanatory factors will be discussed.