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[Diastolic dysfunction, left ventricular hypertrophy, and microalbuminuria in mild to moderate essential arterial
M de Mora Martín1, P Aranda Lara, F J Aranda Lara
1Servicio de Cardiología, Hospital Regional Carlos Haya, Málaga.
Insights
In mild hypertensive patients, microalbuminuria and left ventricular hypertrophy are common, but this study found no direct relationship between them or diastolic dysfunction. Most patients showed signs of cardiac or renal disease.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Background:
- Left ventricular diastolic dysfunction and hypertrophy are prevalent in hypertension.
- Limited data exists on the link between these cardiac conditions and microalbuminuria in hypertensive individuals.
Purpose of the Study:
- To assess the prevalence of microalbuminuria, diastolic dysfunction, and left ventricular hypertrophy.
- To investigate the relationship among these conditions in young, untreated, non-diabetic hypertensive patients.
Main Methods:
- Prospective study of 80 untreated hypertensive patients (mean age 41.4 years).
- Doppler Echocardiography used to evaluate diastolic filling indexes.
- Left ventricular hypertrophy assessed by Devereux's criteria.
- Microalbuminuria measured via radioimmunoassay (30-300 mg/24 hours).
Main Results:
- Prevalence: Microalbuminuria (23.7%), Left Ventricular Hypertrophy (40%), Diastolic Dysfunction (48.8%).
- No significant correlation found between microalbuminuria, hypertrophy, and diastolic dysfunction.
- Only 29.5% of patients were free from cardiac or renal disease.
- Diastolic filling indexes showed differences with microalbuminuria, but regression analysis found no correlation.
Conclusions:
- A high prevalence of cardiac and/or renal disease exists in mild hypertensive patients.
- This study did not find a direct relationship between microalbuminuria and cardiac structural/functional changes in this population.
- Age and diastolic blood pressure were independently related to diastolic filling indexes.
Introduction:
It is known, that there is a high prevalence of left ventricular diastolic disfunction, which precedes left ventricular hypertrophy in hypertensive people, but there is little published in literature about the relationship between these findings and the presence of microalbuminuria.
Objective:
In our study, we pretend to evaluate prevalence and eventual relation among microalbuminuria, diastolic disfunction and left ventricular hypertrophy, in young mild to moderate hypertensive patients, non diabetic and without previous treatment.
Material And Methods:
We studied prospectively 80 untreated hypertensive patients, with normal serum creatinine, and non diabetic (52.5% women and 47.5% men, mean age 41.4 +/- 9.6 years). We evaluated filling indexes by Doppler Echocardiography: Ratio of early to late diastolic peak filling velocity and early filling deceleration time. Left ventricular hypertrophy was defined by Devereux's criteria. Microalbuminuria in twenty four hours was measured by radioimmunoassay in hypertensive patients (microalbuminuria: 30-300 mg/24 hours).
Results:
Microalbuminuria occurred in 23.7%, left ventricular hypertrophy 40%, and diastolic disfunction 48.8%, no significant correlation existed between the same. Only 29.5% had no cardiac or renal disease. Statistically significant differences were found in ratio of early to late diastolic peak filling velocity and microalbuminuria, between the two study populations, but multiple regression analysis didn't prove such correlation. Ratio of early to late diastolic peak filling velocity was independently related to age and diastolic blood pressure.
Conclusions:
There is a high prevalence of cardiac and/or renal disease in mild hypertensive patients, only 29.5% of these patients are free of disease. We don't find relation between lesions in these organs.