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Importance of overweight in studies of left ventricular hypertrophy and diastolic function in mild systemic
B Egan1, M A Fitzpatrick, J Juni
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
Insights
Mild hypertension did not significantly alter forearm vascular resistance or left ventricular structure and function despite elevated blood pressure (BP). Relative weight correlated with diastolic function and left ventricular mass in men.
Area of Science:
- Cardiology
- Hypertension Research
- Vascular Physiology
Background:
- Untreated mild hypertension is common, but its early effects on cardiovascular structure and function are not fully understood.
- Assessing forearm vascular resistance, left ventricular (LV) mass, and diastolic function provides insights into cardiovascular adaptation.
- Metropolitan Life Insurance Co. Relative Weight is a common anthropometric measure.
Purpose of the Study:
- To investigate the relationship between relative weight, blood pressure (BP), and cardiovascular parameters in men with and without mild hypertension.
- To compare forearm vascular resistance, LV structure (septal and posterior wall thickness, LV mass index), and diastolic function between hypertensive and normotensive individuals.
Main Methods:
- Cross-sectional study comparing 18 men with untreated mild hypertension and 13 normotensive controls.
- Measurements included clinic and home blood pressure, minimal forearm vascular resistance, ventricular septal and posterior wall thickness, LV mass index, and diastolic peak filling rate.
- Statistical analysis to compare groups and assess correlations between variables.
Main Results:
- Hypertensive men had significantly higher clinic and home BP than normotensive controls.
- Despite higher BP, no significant differences were found in minimal forearm vascular resistance, ventricular septal/posterior wall thickness, LV mass index, or diastolic peak filling rate between groups.
- Relative weight showed significant negative correlations with diastolic peak filling rate and positive correlations with posterior wall thickness, septal thickness, and LV mass index.
Conclusions:
- Mild hypertension, in the absence of treatment, may not significantly impact forearm vascular resistance or LV structure/diastolic function in middle-aged men.
- Relative weight is a significant correlate of diastolic function and LV geometry, suggesting its importance in cardiovascular health.
- Further research is needed to understand the long-term cardiovascular implications of mild hypertension and the role of body composition.
Abstract:
The relations of Metropolitan Life Insurance Co. Relative Weight values and blood pressure (BP) to minimal forearm vascular resistance, ventricular septal and posterior wall thickness, left ventricular (LV) mass index and cardiac diastolic function were assessed in 31 men, 37 +/- 2 (mean +/- standard error of the mean) years of age. Eighteen patients with untreated mild hypertension were compared with 13 normotensive control subjects of similar age and weight. The hypertensives had higher clinic (137 +/- 3/96 +/- 2 vs 121 +/- 4/81 +/- 3 mm Hg, p less than 0.001/less than 0.001) and home (p less than 0.001) BP. Despite higher BP, the hypertensives did not have significantly greater values than normotensives, respectively, for minimal forearm vascular resistance (2.20 +/- 0.12 vs 2.04 +/- 0.11 U), ventricular septal (9.9 +/- 0.5 vs 10.2 +/- 0.3 mm) and posterior wall thickness (10.2 +/- 0.4 vs 10.0 +/- 0.3 mm) or LV mass index (106 +/- 6 vs 107 +/- 6 g/m2). Furthermore, diastolic peak filling rate, an index of LV diastolic function, was virtually identical in the 2 groups (2.71 +/- 0.14 vs 2.69 +/- 0.07 liters/s, difference not significant). Correlates of peak filling rate included relative weight (r = -0.62, p less than 0.001), posterior wall thickness (r = -0.51, p less than 0.01) and age (r = -0.45, p less than 0.05). Relative weight also correlated significantly with posterior wall (r = 0.59, p less than 0.005), ventricular septal (r = 0.47, p less than 0.005) and LV mass index (r = 0.38, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)