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Left ventricular hypertrophy and geometry in hypertensive patients with chronic kidney disease

Emilio Nardi1, Alessandro Palermo, Giuseppe Mulè

  • 1Dipartimento di Medicina Interna, Cattedra di Medicina Interna and Hypertension Excellence Centre of the European Society of Hypertension, Università degli Studi di Palermo, Palermo, Italy. emilionardi@virgilio.it

Journal of Hypertension
|March 6, 2009
PubMed

Insights

Left ventricular hypertrophy (LVH) is common in chronic kidney disease (CKD) patients, often inappropriate and linked to worsening renal function. This study compared LVH in hypertensive patients with CKD versus those with normal kidney function.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Hypertension

Background:

  • Hypertension is a major risk factor for cardiovascular complications.
  • Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality.
  • Left ventricular hypertrophy (LVH) is a common cardiac adaptation in hypertensive patients.

Purpose of the Study:

  • To determine the prevalence of LVH and left ventricular geometry in hypertensive patients with stages 2-5 CKD.
  • To compare LVH and geometry between hypertensive patients with CKD and those with normal renal function.

Main Methods:

  • Echocardiographic examination was performed on 293 hypertensive patients with CKD (stage 2-5) and 289 hypertensive patients with normal renal function.
  • Exclusion criteria included stage 1 CKD, dialysis, and pre-existing cardiovascular diseases.

Main Results:

  • LVH prevalence was significantly higher in CKD patients (47.1%) compared to controls (31.14%).
  • CKD patients showed increased left ventricular diameters, thicknesses, and mass, particularly in advanced stages.
  • Inappropriate left ventricular mass was more prevalent in CKD patients (52.6%) vs. controls (30.5%).
  • Renal function independently associated with left ventricular mass; diastolic function was impaired in CKD patients.

Conclusions:

  • LVH is highly prevalent in hypertensive patients with CKD.
  • LVH in CKD patients is often inappropriate, with increased wall thickness and diameter.
  • Worsening renal function correlates with increased left ventricular mass and impaired diastolic function.
Abstract

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