Relation of genetic predisposition and insulin resistance to left ventricular hypertrophy in hypertension.
BACKGROUND
The aim of the study was to determine whether genetic predisposition to hypertension and insulin resistance are related to left ventricular (LV) hypertrophy in essential hypertension.


METHODS
The study included 72 nondiabetic patients with essential hypertension and 15 normotensive control (NC) subjects. The 72 patients were divided into two groups according to genetic predisposition to hypertension. The family history (FH)(+) group included 33 patients with at least one essential hypertensive parent or sibling. The FH(-) group included 39 patients with weak genetic predisposition to hypertension. Insulin resistance was estimated using the homeostasis model assessment (HOMA). Echocardiographically determined LV mass (LVM) and relative wall thickness (RWT) were measured as markers of LV hypertrophy.


RESULTS
The HOMA values in the FH(+) group (2.00 +/- 0.89) were significantly higher than those in either the FH(-) group (1.21 +/- 0.44) or NC subject group (0.91 +/- 0.24). The HOMA values in the FH(-) group were significantly higher than those in NC subjects. The LVM and RWT were greatest in the FH(+) group, followed by those in the FH(-) group and NC subjects. There were no significant differences in LVM and RWT between the FH(-) group and NC subjects. By multivariate analysis, HOMA value (P = .0011), male sex (P = .0032), body mass index (P = .0061), systolic blood pressure (P = .0245), and genetic predisposition to hypertension (P = .0441) remained determinants of LVM in nondiabetic patients with essential hypertension.


CONCLUSIONS
Genetic predisposition to hypertension and the HOMA value appear to have additive impact on LV hypertrophy. This relation is independent of well-known determinants of LVM such as male sex, overweight, and high blood pressure.
Shigematsu
Yuji
Y
The Second Department of Internal Medicine, Ehime University School of Medicine, Shitsukawa, Toon-city, Ehime, Japan. yujis@m.ehime-u.ac.jp
Hara
Yuji
Y
Ohtsuka
Tomoaki
T
Ohgimoto
Akiyoshi
A
Inoue
Katsuji
K
Higaki
Jitsuo
J
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D004452:Echocardiography; D005260:Female; D020022:Genetic Predisposition to Disease; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000235:genetics* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012737:Sex Factors; D013599:Systole