Kidney function and risk factors for left ventricular hypertrophy in untreated uncomplicated essential hypertension.
BACKGROUND
Left ventricular (LV) hypertrophy and decreased kidney function are well-established cardiovascular risk factors in hypertensive patients.


METHODS
We investigated the relationship between creatinine level, creatinine clearance, and estimated glomerular filtration rate (eGFR) with LV mass (LVM) in a cross-sectional study.


METHODS
eGFR and serum creatinine level.


RESULTS
LVM index (LVMI).


METHODS
400 patients with untreated uncomplicated essential hypertension.


METHODS
LVMI, eGFR (Modification of Diet in Renal Disease Study equation), Framingham risk factors, and a series of specific risk factors, ie, endothelial function (acetylcholine [ACh]-stimulated forearm blood flow [FBF]), insulin sensitivity (Homeostatic Model Assessment for insulin resistance [HOMA-R] index), C-reactive protein (CRP), and uric acid.


RESULTS
Both eGFR and creatinine level were significantly related to LVMI (r = -0.34 and r = 0.35; P < 0.001). In a multiple regression model adjusting for Framingham risk factors, eGFR was independently associated with LVMI. However, this association, although highly significant, lost substantial strength after adjustment for such specific risk factors as HOMA-R index, ACh-stimulated FBF, CRP level, and uric acid level. eGFR interacted with insulin resistance in explaining the variability in LVMI (P = 0.007).


CONCLUSIONS
The cross-sectional nature of this study precludes cause-effect conclusions.


CONCLUSIONS
Independently of other risk factors, decreased kidney function contributes to explain the variability in LVMI in patients with untreated uncomplicated essential hypertension. This association is attributable in part to the link between eGFR and such specific risk factors as HOMA-R index, ACh-stimulated FBF, CRP level, and uric acid level. Decreased kidney function and insulin resistance interact in explaining the variability in LVMI in these patients.
Perticone
Francesco
F
Department of Experimental and Clinical Medicine, G. Salvatore, University Magna Graecia of Catanzaro, Reggio Calabria, Italy.
Maio
Raffaele
R
Ruberto
Carmen
C
Cassano
Susanna
S
Tripepi
Giovanni
G
Perticone
Maria
M
Sesti
Giorgio
G
Zoccali
Carmine
C
D000328:Adult; D017677:Age Distribution; D001795:Blood Pressure Determination; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D003404:Creatinine / Q000097:blood*; D015150:Echocardiography, Doppler; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate
D008078:Cholesterol, LDL; D002097:C-Reactive Protein; D003404:Creatinine