Background Diabetes and
hypertension have been associated with adverse left ventricular (LV) remodeling. While they often occur concurrently, their individual effects are understudied. We aimed to assess the independent effects of diabetes and
hypertension on LV remodeling in Black adults. Methods and Results The JHS (Jackson Heart Study) participants (n=4143 Black adults) with echocardiographic measures from baseline exam were stratified into 4 groups: neither diabetes nor
hypertension (n=1643), only diabetes (n=152), only
hypertension (n=1669), or both diabetes and
hypertension (n=679). Echocardiographic measures of LV structure and function among these groups were evaluated by multivariable regression adjusting for covariates. Mean age of the participants was 52±1 years, and 63.7% were women. LV mass index was not different in participants with only diabetes compared with participants with neither diabetes nor
hypertension (P=0.8). LV mass index was 7.9% (6.0 g/m2) higher in participants with only
hypertension and 10.8% (8.1 g/m2) higher in participants with both diabetes and
hypertension compared with those with neither (P<0.001). LV wall thickness (relative, posterior, and septal) and
brain natriuretic peptide levels in participants with only diabetes were not significantly higher than participants with neither (P>0.05). However, participants with both diabetes and
hypertension demonstrated higher LV wall thickness and
brain natriuretic peptide levels than participants with neither (P<0.05). Conclusions In this cross-sectional analysis, diabetes was not associated with altered LV structure or function in Black adults unless participants also had
hypertension. Our findings suggest
hypertension is the main contributor to cardiac structural and functional changes in Black adults with diabetes.