High-density lipoprotein cholesterol and insulin resistance are independent and additive markers of left ventricular hypertrophy in essential hypertension.
We examined whether plasma high-density lipoprotein-cholesterol (HDL-C) levels and glucose metabolism parameters are independent or additive predictors of left ventricular hypertrophy (LVH) in patients with untreated essential hypertension. The study group consisted of 41 Japanese patients with untreated essential hypertension and LVH (left ventricular mass index [LVMI] >125 g/m2; age 58+/-6 years, mean+/-SD), and the control group consisted of 39 age-matched patients with untreated essential hypertension without LVH (LVMI <or=125 g/m2; age 58+/-7 years). The following metabolic parameters were higher in the group with LVH: fasting plasma glucose (FPG) (p<0.01), fasting insulin concentration (F-IRI) (p<0.0001), and homeostasis model assessment (HOMA)-index (p<0.0001). Among the laboratory parameters investigated, plasma HDL-C levels were lower (p<0.0001), and triglyceride and uric acid levels were higher in the group with LVH (p<0.05 for both). The nighttime systolic and diastolic ambulatory blood pressure (ABP) (p<0.0001, p<0.01, respectively) and nighttime heart rate (p<0.01) were higher in patients with LVH. Multivariate logistic analysis identified HDL-C (odds ratio [OR]=0.92, 95% confidence interval [CI]=0.87-0.98, p<0.05), HOMA-index (OR=3.83, 95% CI=1.28-11.5, p<0.05) and nighttime systolic ambulatory blood pressure (ABP) (OR=1.06, 95% CI=1.00-1.13, p<0.05) as independent significant risk factors for LVH. Our findings suggest that HDL-C, HOMA-index and nighttime systolic ABP are independent predictors for the presence of LVH in Japanese patients with essential hypertension.
Anan
Futoshi
F
Department of Cardiovascular Science, Faculty of Medicine, Oita University, Japan. anan-f@med.oita-u.ac.jp
Yonemochi
Hidetoshi
H
Masaki
Takayuki
T
Takahashi
Naohiko
N
Fukunaga
Naoya
N
Teshima
Yasushi
Y
Iwao
Tetsu
T
Kaneda
Koji
K
Eshima
Nobuoki
N
Saikawa
Tetsunori
T
Yoshimatsu
Hironobu
H
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001795:Blood Pressure Determination; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012306:Risk; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D014280:Triglycerides; D014527:Uric Acid