Diastolic dysfunction is associated with insulin resistance, but not with aldosterone level in normotensive offspring of hypertensive families.
OBJECTIVE
We investigated left ventricular (LV) morphology and function in association with insulin level/insulin resistance (IR) and aldosterone level in normotensive offspring of subjects with essential hypertension (familial trait, FT).


METHODS
The study encompassed 76 volunteers of whom 44 were normotensive with FT (aged 28-39 years) and 32 age-matched controls without FT. LV mass and function were measured using conventional echocardiography and tissue Doppler imaging. LV diastolic function was reported as peak septal annular velocities (E(m) and E(m)/A(m) ratio) in tissue Doppler imaging. Fasting insulin and aldosterone were determined.


RESULTS
In subjects with FT, the LV mass was higher than in controls (92.14 +/- 24.02 vs. 70.08 +/- 20.58 g; p < 0.001). The study group had a worse LV diastolic function than control subjects (lower E(m) and E(m)/A(m) ratio; p < 0.001). In subjects with FT, the E(m)/A(m) ratio was independently associated with IR (partial p = 0.029 in multivariate model, R(2) = 0.51), but not with LV mass. The aldosterone level was comparable in both groups.


CONCLUSIONS
In normotensive individuals with FT, LV morphological and functional abnormalities were found. LV dysfunction but not an increase in LV mass is associated with IR. The aldosterone level is probably not responsible for the development of early hypertensive heart disease.
Zizek
Bogomir
B
Department of Angiology, University Medical Centre, Ljubljana, Slovenia. drzizek@hotmail.com
Poredos
Pavel
P
Trojar
Andrej
A
Zeljko
Tadej
T
D000328:Adult; D000450:Aldosterone / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D054144:Heart Failure, Diastolic / Q000235:genetics* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000235:genetics* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D007333:Insulin Resistance; D008297:Male
D000450:Aldosterone