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Glomerular hyperfiltration indicates early target organ damage in essential hypertension
R E Schmieder1, F H Messerli, G Garavaglia
1Department of Medicine, University of Bonn, Bonn-Venusberg, Federal Republic of Germany.
JAMA
|December 5, 1990
Summary
In essential hypertension, a high glomerular filtration rate (GFR) is linked to early left ventricular hypertrophy. This finding suggests GFR may indicate early target organ damage in hypertensive patients.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Background:
- Essential hypertension is a leading cause of cardiovascular disease.
- Left ventricular hypertrophy (LVH) is an early sign of cardiac damage in hypertension.
- The relationship between renal hemodynamics and LVH in early-stage hypertension requires further elucidation.
Purpose of the Study:
- To investigate the association between renal hemodynamic parameters and left ventricular hypertrophy in patients with essential hypertension.
- To determine if glomerular filtration rate (GFR) or renal blood flow predicts early cardiac structural changes.
Main Methods:
- Echocardiography was used to assess left ventricular structure in 111 patients.
- Iodine I 131 aminohippuric acid clearance measured renal blood flow.
- Creatinine clearance determined glomerular filtration rate.
Main Results:
- GFR showed a positive correlation with left ventricular mass (r = .52) and cross-sectional area (r = .21).
- Hypertensive patients with LVH exhibited a higher GFR and filtration fraction compared to those without LVH, even at similar arterial pressure and body mass.
- Renal blood flow and renal vascular resistance did not differ significantly between groups.
Conclusions:
- Glomerular hyperfiltration is associated with early cardiac structural changes in essential hypertension.
- A high GFR may serve as an early indicator of target organ damage in hypertensive individuals with normal renal function.