Determinants of left ventricular hypertrophy in hypertensive patients: Identification of high-risk patients by metabolic, vascular, and inflammatory risk factors

Maya Peer, Mona Boaz, Matas Zipora, Marina Shargorodsky

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Left ventricular hypertrophy (LVH) is recognized as an independent predictor of cardiovascular morbidity and mortality in hypertensive patients. Thus, it is critical to understand the mechanisms underlying the development of LVH for formulation screening and treatment strategies. This study was designed to determine the association between echographically determined LVH measures and markers of inflammation, neurohormonal activity, glomerular function, oxidative stress, insulin resistance, and vascular endothelial function. In this study, 129 hypertensive subjects were evaluated for lipids, glucose, HbA1C, insulin, homeostasis model assessment-insulin resistance, C-reactive protein (CRP), urinary microalbumin, homocysteine, aldosterone, renin, and endothelin. LVH parameters including interventricular septum thickness, posterior wall thickness (PWT), and left ventricular mass index (LVMI) were assessed echographically. Serum aldosterone levels were significantly positively associated with left ventricular mass (LVM) and marginally positively associated with LVMI and PWT. Both LVM and LVMI were significantly elevated in subjects with high versus normal serum aldosterone levels (p = 0.018 for LVM and p = 0.050 for LVMI). Serum endothelin was positively associated with LVM and LVMI. In multiple linear regression analysis, aldosterone remained a significant predictor of LVM (standardized β = 0.229, p = 0.024), and endothelin a marginally significant predictor of LVM (standardized β = 0.178, p = 0.077). Among serum lipids, high-density lipoprotein cholesterol only had a significant inverse association with LVM and PWT. Homocysteine as well as CRP were significantly positively associated with LVM and LVMI in females. This study found that aldosterone and endothelin levels are the most important independent determinants of LVH in hypertensive subjects. These markers may be useful to identify asymptomatic hypertensive subjects at risk for heart failure.

Original languageEnglish
Pages (from-to)223-228
Number of pages6
JournalInternational Journal of Angiology
Volume22
Issue number4
DOIs
StatePublished - Dec 2013
Externally publishedYes

Keywords

  • cardiovascular disease
  • cardiovascular risk factors
  • creatinine
  • high-sensitivity C-reactive protein
  • hypercholesterolemia
  • hypertension

Fingerprint

Dive into the research topics of 'Determinants of left ventricular hypertrophy in hypertensive patients: Identification of high-risk patients by metabolic, vascular, and inflammatory risk factors'. Together they form a unique fingerprint.

Cite this