title: Obesity and daytime pulse pressure are predictors of left ventricular hypertrophy in true normotensive individuals.
abstract: OBJECTIVE
  To investigate predictors of left ventricular mass corrected for height2.7 (LVMI) and left ventricular hypertrophy in patients who were found to be normotensive with both office and 24-h ambulatory blood pressure (BP) measurements.
  
  
  METHODS
  A total of 805 consecutive patients were analyzed. All patients underwent office BP measurements, 24-h ambulatory BP monitoring, laboratory measurements for cardiovascular risk factors and echocardiography. Individuals with both office and ambulatory normotension were characterized as true normotensive.
  
  
  RESULTS
  LVMI was found to be 34.5 +/- 10.9 g/m2.7 in normal-weight patients and 48.7 +/- 13.0 g/m2.7 in obese patients (P < 0.0001). LVMI was found to be 41.7 +/- 10 g/m2.7 in overweight patients, significantly lower than the values of obese patients (P < 0.005) and higher than the values of normal-weight patients (P < 0.001). These results remained significant even after adjustment for age, sex, daytime and nighttime SBP, daytime and nighttime DBP, daytime and nighttime BP variability and daytime and nighttime pulse pressure (PP). In a multivariate analysis model, in which LVMI was the dependent variable and office SBP, office DBP, daytime and nighttime SBP and DBP, daytime and nighttime PPs and variabilities, day-night SBP ratio, fasting serum glucose, triglycerides, total cholesterol, age and BMI were inserted as independent variables with weighted least squares regression by sex, the predictors of LVMI were age, BMI and daytime PP (r2 = 0.31). Left ventricular hypertrophy was 17.67 times more likely in obese patients as compared with normal-weight true normotensive individuals.
  
  
  CONCLUSIONS
  Obesity may represent a significant cardiovascular risk factor even in normotensive individuals. Other predictors of LVMI were ageing and daytime PP.
authors.affiliation: Hypertension Center, Third Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. bkotsis@med.uoa.gr
authors.forename: Vasilios
authors.initials: V
authors.lastname: Kotsis
authors.forename: Stella
authors.initials: S
authors.lastname: Stabouli
authors.forename: Savvas
authors.initials: S
authors.lastname: Toumanidis
authors.forename: George
authors.initials: G
authors.lastname: Tsivgoulis
authors.forename: Zoe
authors.initials: Z
authors.lastname: Rizos
authors.forename: Christine
authors.initials: C
authors.lastname: Trakateli
authors.forename: Nikos
authors.initials: N
authors.lastname: Zakopoulos
authors.forename: Michael
authors.initials: M
authors.lastname: Sion
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D012307:Risk Factors; D055815:Young Adult