Left ventricular hypertrophy in hypertensive type 2 diabetic patients according to renal function.
OBJECTIVE
Cardiovascular disease is the main cause of death in diabetic patients undergoing haemodialysis. Dialysis and hypertension increase left ventricular hypertrophy (LVH), a strong predictor of cardiovascular events. This study evaluated left ventricular structure and function in three groups of hypertensive type 2 diabetic patients with different renal function, and assessed the factors associated with LVH, in an Afro-Caribbean population.


METHODS
Left ventricular structure and function were measured by ultrasonography. Group 1 consisted of 150 patients with normal renal function, group 2 included 183 patients with renal dysfunction and the third group comprised 75 dialysis patients.


RESULTS
Left ventricular mass/height(2.7) increased from group 1 to groups 2 and 3 (49.00g/m(2.7), 57.12g/m(2.7) and 59.75g/m(2.7), respectively; P<0.0001). The prevalences of LVH were 48.3% in group 1, 64.8% in group 2 and 70.3% in the dialysis patients (P=0.001). LVH was more concentric than eccentric in groups 2 and 3. The factors significantly associated with LVH were obesity in groups 1 and 2, and an increase of 10mmHg in pulse pressure in groups 2 and 3, according to multivariate logistic-regression analysis.


CONCLUSIONS
Our study confirmed that, in a population of Afro-Caribbean hypertensive type 2 diabetic patients, renal failure was associated to an increased left ventricular mass/height(2.7). The data show that the variables associated with LVH differ according to renal profile. This finding will be of value in the treatment and follow-up of these patients.
Blanchet Deverly
A
A
CHU de Point-à-Pitre Abymes, Guadeloupe. anne.blanchet.deverly@wanadoo.fr
Kangambega
P
P
Hue
K
K
Donnet
J-P
JP
Merault
H
H
Foucan
L
L
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000145:classification / Q000209:etiology* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D006435:Renal Dialysis / Q000706:statistics & numerical data; D051437:Renal Insufficiency / Q000150:complications*; D012307:Risk Factors; D013223:Statistics as Topic
D000959:Antihypertensive Agents