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Relationship between left ventricular mass index and 24-h urinary free cortisol and cortisone in essential arterial
D Duprez1, M De Buyzere, M Paelinck
1Department of Cardiology and Angiology, University Hospital, Gent, Belgium.
Insights
In essential hypertension, elevated cortisol levels are linked to increased left ventricular mass index (LVMI), indicating cardiac hypertrophy. This relationship exists independently of arterial blood pressure in untreated patients.
Area of Science:
- Cardiology
- Endocrinology
- Hypertension Research
Background:
- Non-hemodynamic factors, such as elevated cortisol, can contribute to cardiac hypertrophy.
- Cushing's syndrome demonstrates a link between high cortisol and ventricular hypertrophy, alongside increased aortic pressure.
Purpose of the Study:
- To investigate the association between cortisol/cortisone levels and left ventricular mass index (LVMI).
- To examine this relationship in patients with essential arterial hypertension, with and without echocardiographic left ventricular hypertrophy (LVH).
Main Methods:
- Eighteen untreated essential hypertension patients and 13 normotensive controls were enrolled.
- Echocardiography assessed left ventricular dimensions.
- 24-hour urinary free cortisol and cortisone concentrations evaluated cortisol production.
Main Results:
- LVMI correlated significantly with 24-hour urinary free cortisol (r=0.61) and cortisone (r=0.60).
- Patients with LVH exhibited higher daytime blood pressure, LVMI, and urinary cortisol.
- Cortisol and cortisone levels did not correlate with LVMI in the control group.
Conclusions:
- A significant relationship exists between LVMI and cortisol production in untreated hypertension.
- This association is independent of arterial blood pressure levels.
Objective:
Besides arterial blood pressure, nonhemodynamic factors are known to induce cardiac hypertrophy. In Cushing's syndrome, severe ventricular hypertrophy has been linked not only to increased aortic pressure, but also to elevated plasma cortisol. The aim of this study was to examine the relationship between the cortisol/cortisone levels and left ventricular mass index (LVMI) in essential arterial hypertension with and without echocardiographic left ventricular hypertrophy (LVH).
Design:
Eighteen untreated Caucasian patients (nine men, nine women, mean age 48+/-6 years) with essential hypertension (163+/-26/100+/-14 mm Hg) were enrolled. An age-matched control group of 13 subjects (seven men, six women) with normotension (121+/-9/79+/-7 mm Hg) were enrolled also. Left ventricular dimensions were echocardiographically assessed and cortisol production evaluated by 24-h urinary free cortisol and cortisone concentrations.
Results:
LVMI averaged 115+/-31 g/m2 and 24-h urinary free cortisol and cortisone were 23+/-14 microg per 24 h and 31+/-18 microg per 24 h. Prevalence of echocardiographic LVH was 56%. LVMI correlated significantly with 24-h urinary free cortisol (r = 0.61, P = 0.007) and cortisone (r = 0.60, P = 0.009). Patients with echocardiographic LVH were characterized by higher daytime ambulatory blood pressure, LVMI (particularly the posterior wall), and 24-h urinary cortisol, while office blood pressure, septal: posterior wall ratio and 24-h urinary cortisone were comparable in all patients. In control individuals, LVMI averaged 91+/-18 g/m2 and 24-h urinary free cortisol and cortisone, respectively, were 34.7+/-6.6 microg per 24 h and 64.3+/-10.8 microg per 24 h (P<0.05 versus patients). Neither LVMI nor the contributing ventricular dimensions showed significant correlation with 24-h urinary free cortisol or cortisone in the control group.
Conclusions:
Our data provide evidence for a significant relationship between LVMI and cortisol production independently of arterial blood pressure in untreated mild to moderate hypertension.