High-density lipoprotein cholesterol and left ventricular hypertrophy in essential hypertension.
OBJECTIVE
The proportion of left ventricular (LV) mass variability explained by blood pressure in essential hypertension is small, and several non-haemodynamic determinants of LV mass have been identified or hypothesized. This study examines the possible relation between blood lipids and LV mass in hypertension.


METHODS
Never-treated non-diabetic hypertensive patients.


METHODS
Hospital hypertension outpatient clinics in Umbria, Italy.


METHODS
We investigated the association between high-density lipoprotein (HDL)-cholesterol and echocardiographic LV mass in 1306 never-treated subjects with essential hypertension. Subjects with previous cardiovascular events, diabetes and current or previous antihypertensive or lipid-lowering therapy were excluded.


RESULTS
HDL-cholesterol showed an inverse association with LV mass (r = -0.30, P < 0.001). No association was found between LV mass and total or low-density lipoprotein cholesterol. With multiple linear regression analysis we tested the independent contribution of several potential determinants of LV mass in women and in men. Average 24 h blood pressure (both pulse and mean), body mass index, height, stroke volume, age (all P < 0.01) and low HDL-cholesterol (P < 0.0001 in women, P < 0.001 in men) were associated with a greater LV mass in both sexes. Triglycerides showed a weak univariate association with LV mass in women (r = 0.11, P < 0.02), which did not hold in a multivariate analysis.


CONCLUSIONS
Low HDL-cholesterol is an independent predictor of LV mass in untreated hypertensive subjects. Common hormonal and metabolic mechanisms, including insulin resistance, could explain this association, which may contribute to the adverse prognostic significance of low HDL-cholesterol levels.
Schillaci
G
G
Unit of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. skill@unipg.it
Vaudo
G
G
Reboldi
G
G
Verdecchia
P
P
Lupattelli
G
G
Pasqualini
L
L
Porcellati
C
C
Mannarino
E
E
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications* / Q000000981:diagnostic imaging; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012727:Sex Characteristics; D013318:Stroke Volume
D008076:Cholesterol, HDL; D008055:Lipids