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


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.

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


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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.


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.

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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.

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Correspondence to Tazeen H. Jafar.

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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).

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