Family history of hypertension influences left ventricular diastolic function during chronic antihypertensive therapy.
BACKGROUND
Genetic factors play an important role in linking insulin resistance and hypertension, also influencing insulin sensitivity changes during antihypertensive treatment. This study was aimed to evaluate whether genetic predisposition to hypertension can also influence left ventricular (LV) changes during antihypertensive treatment.


METHODS
We enrolled 36 never-treated hypertensives: 18 with both parents hypertensive (F+) and 18 with both parents normotensive (F-), matched for age, gender, and body mass index (BMI). The patients were evaluated twice, before and after 2.5 years of treatment with enalapril. At both evaluations the patients underwent: 24-h blood pressure (BP) monitoring, LV echocardiogram, and oral glucose tolerance test, with measurements of glucose and insulin levels.


RESULTS
At basal evaluation the two groups were not different with regard to gender, age, BMI, 24-h BP, and fasting glucose; glucose metabolic clearance rate was significantly lower in F+. The LV mass index was similar between the groups, whereas diastolic parameters were significantly lower in F+. At second evaluation, 24-h BP and LV mass were decreased to the same extent in both groups; glucose metabolic clearance rate significantly increased in F- and remained unchanged in F+. The improvement of LV diastolic function, found in both group, was significantly greater in F-.


CONCLUSIONS
Genetic predisposition to hypertension, in addition to affecting insulin sensitivity, influences LV functional changes during antihypertensive treatment. Despite a similar extent of 24-h BP and LV mass decrease, F+ patients showed no changes in insulin sensitivity and a smaller improvement in LV diastolic function than F-.
Grandi
Anna M
AM
Department of Clinical Medicine, University of Insubria, Varese, Italy. amgrandi@libero.it
Laurita
Emanuela
E
Marchesi
Chiara
C
Maresca
Andrea
A
Solbiati
Francesco
F
Nicolini
Eleonora
E
Gianni
Monica
M
Guasti
Luigina
L
Venco
Achille
A
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology; D006332:Cardiomegaly / Q000235:genetics / Q000503:physiopathology; D004562:Electrocardiography; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D020022:Genetic Predisposition to Disease; D005951:Glucose Tolerance Test; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000235:genetics* / Q000503:physiopathology; D007333:Insulin Resistance / Q000235:genetics / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000235:genetics* / Q000503:physiopathology
D000959:Antihypertensive Agents; D001786:Blood Glucose; D004656:Enalapril