The purpose of this supplement to Dr. Martha Hill's YBMII hypertension study, is to evaluate the difference in left ventricular mass (LVM), measured with echocardiography, between the men in the special intervention versus the men in the usual care group. The hypothesis is that the special intervention will lead to a smaller increase in LVM over 2 years of follow-up than the usual care group, or to a reduction in LVM. In addition, we are measuring changes in voltage on ECG, as a secondary measure of LVM regression, and carotid tonometry measurement of augmentation index as a measure of central vascular stiffness. Plasma renin and angiotensin II are measured to define the presence of low renin hypertension in this group of African-American men. The buffy coat is saved for DNA analysis of genetic polymorphisms related to the renin-angiotensin system. We will analyze the association between renin and angiotensin II levels and left ventricular hypertrophy, and also the association between genetic polymorphisms and left ventricular hypertrophy.
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