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The relation between cardiac hypertrophy and hypertension
Insights
Left ventricular mass, a measure of heart muscle size, is linked to blood pressure and other factors in middle-aged men. Other influences, not just blood pressure, likely affect heart changes in hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Physiology
Background:
- Left ventricular mass (LVM) is a key indicator of cardiac health.
- Hypertension is a major risk factor for cardiovascular disease.
- Understanding factors influencing LVM is crucial for managing cardiovascular risk.
Purpose of the Study:
- To investigate the relationship between left ventricular mass and blood pressure in 49-year-old men.
- To explore associations between LVM and sympathetic activity, renin-angiotensin-aldosterone system, and glucose metabolism.
- To identify factors modifying the hypertrophic response to elevated blood pressure.
Main Methods:
- Stratified random sampling of 120 men aged 49.
- Echocardiographic determination of left ventricular mass.
- Measurement of blood pressure, including during isometric exercise.
- Assessment of sympathetic activity (urinary noradrenaline), renin-angiotensin-aldosterone system (plasma aldosterone), and glucose metabolism (blood glucose, plasma insulin).
Main Results:
- A poor overall correlation between LVM and resting blood pressure was observed.
- In the upper blood pressure range, LVM correlated with isometric exercise blood pressure, urinary noradrenaline, and plasma aldosterone.
- In the intermediate blood pressure range, LVM was associated with blood glucose and plasma insulin.
Conclusions:
- Blood pressure alone is a poor predictor of left ventricular mass in the studied population.
- Sympathetic activity, the renin-angiotensin-aldosterone system, and metabolic factors play significant roles in modulating left ventricular mass.
- In mild to moderate hypertension, factors beyond arterial pressure likely influence cardiac hypertrophy.
Abstract:
Left ventricular mass determined echocardiographically was related to blood pressure in a stratified random sample (n = 120) of 49-year-old men selected from a blood pressure screening and covering a wide range of blood pressures. Only subjects not on antihypertensive treatment were studied. Left ventricular mass was also related to sympathetic activity, the renin-angiotensin-aldosterone system and glucose metabolism. A poor correlation between left ventricular mass and blood pressure was found in the entire study group. In the upper blood pressure range only blood pressure during isometric exercise was significantly correlated with left ventricular mass. In this range there were significant correlations between left ventricular mass and 24 hour urinary noradrenaline excretion and plasma aldosterone. In the intermediate blood pressure range there was an association between left ventricular mass and blood glucose and plasma insulin. It is concluded that in mild to moderate hypertension other factors probably modify the hypertrophic response to rising arterial pressure.