Insulin resistance, ventricular mass and function in normoglycaemic hypertensives.
OBJECTIVE
To investigate the possible relationship between insulin sensitivity and the main non-invasively determined parameters of left ventricular structure and function in an early phase of hypertensive disease.


RESULTS
We studied a group of 60 patients with previously untreated primary arterial hypertension of recent onset. Insulin sensitivity was evaluated by means of homeostasis model assessment (HOMA), and cardiac structure and function by means of ultrasonography. The patients were subsequently divided on the basis of HOMA tertiles and the between-group differences were statistically evaluated using one-way analysis of variance. No difference was found in the main demographic parameters, but high-density lipoprotein (HDL)-cholesterol was significantly higher (1.43 +/- 0.4, 1.16 +/- 0.2, 1.16 +/- 0.2 mmol/L; p < 0.05) and total triglycerides significantly lower (0.94 +/- 0.3, 1.41 +/- 0.8, 1.54 +/- 0.7 mmol/L; p < 0.05) in the first tertile. In relation to the non-invasive parameters of diastolic function, the E wave was significantly reduced in the third tertile (0.64 +/- 0.1, 0.63 +/- 0.1, 0.52 +/- 0.1 m/s; p < 0.05), with a concomitant significant increase in AFF (0.51 +/- 0.03, 0.51 +/- 0.06, 0.56 +/- 0.03; p < 0.05). The E wave (r = 0.326, p < 0.05), E/A wave ratio (r = -0.277, p < 0.05) and AFF (r = 0.432, p < 0.001) were significantly related to HOMA, regardless of age, body mass index, heart rate, left ventricular mass and blood pressure.


CONCLUSIONS
Our results indicate that hypertensive patients in the third HOMA tertile (i.e. those with reduced insulin sensitivity) have early diastolic left ventricular abnormalities.
Guida
L
L
Department of Clinical and Experimental Medicine, Federico II University, Via S. Pansini 5, 80131 Naples, Italy.
Celentano
A
A
Iannuzzi
R
R
Ferrara
L A
LA
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D008076:Cholesterol, HDL / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
D008076:Cholesterol, HDL; D014280:Triglycerides