Myocardial hypertrophy in hypertensive patients with and without metabolic syndrome

Beside arterial hypertension as the most important factor of a myocardial hypertension development, very important risk factors are obesity, hypercholesterolemia, insulin resistance, etc. The aim of the study was to examine the influence of metabolic syndrome (MetS) on left ventricular hypertrophy in patients with arterial hypertension.

We checked medical records for 138 patients with arterial hypertension, and compared them with the control group of 44 normotensive subjects. The patients with arterial hypertension were divided into two groups considering the presence of MetS: with MetS (59 patients), and without MetS (79 patients). We defined MetS as presence of three (or more) within five criteria: central obesity (> 102 cm male, > 88 cm female), raised triglycerides (> 1.7 mmol/L, or drug treatment for elevated triglycerides), reduced high density lipoprotein (HDL) cholesterol (< 1.03 mmol/L male, < 1.3 mmol/L female), raised blood pressure (> 130 mmHg systolic, > 90mmHg diastolic), raised fasting glucose (> 6.11 mmol/L, or drug treatment for elevated glucose level). In each group routine laboratory, echocardiography and 24-hour ambulatory blood pressure monitoring were performed.

We found statisticaly significant higher left ventricular mass in both subgroups hypertensive patients in comparison with the control group (p < 0.05). We did not find statistically significant difference (227.31 +/- 63.44 vs 219 +/- 59.5, p > 0.05) in left ventricular mass between these two groups of patients. In the patients with arterial hypertension and MetS we found hypertrophy more frequently than in the subgroup without MetS (43/57 vs 34/69, p < 0.001).

Our results suggest that associated cardiometabolic risks increase the prevalence of myocardial hypertrophy, but do not influence left ventricular mass.