Left and right ventricular structural changes in obese hypertensives

AIM: Obesity is known to be independently related to left ventricular (LV) hypertrophy (LVH); however, in human hypertension the association of obesity with right ventricular hypertrophy (RVH) is still unsettled. We investigated the relationship of obesity with RVH and biventricular hypertrophy in essential hypertension. METHODS: A cohort of untreated and treated uncomplicated essential hypertensives consecutively attending a hospital outpatient hypertension clinic, categorized in three groups according to body mass index (BMI) thresholds ( or =30 kg/m2) was considered for the present analysis. RVH was defined by an anterior RV wall thickness equal or higher than 3.1/3.0 mm/m2 in men and women, respectively, and LVH by LV mass index (LVMI) equal or higher than 51 and 47 g/m(2.7) in men and women, respectively. RESULTS: A total of 124 patients (37.6%) had normal BMI, 151 patients (45.7%) were overweight and 55 (16.7%) obese. Prevalence rates of biventricular hypertrophy (i.e. LVMI>51 and 47 g/m(2.7) and RVWT>3.1 and 3.0 mm) in the three groups were 7.3%, 21.2% and 32.7%, respectively. In a multivariate analysis, BMI (OR=3.58, 95% CI 1.82-7.03, p=0.0002), was the most important correlate of biventricular hypertrophy. CONCLUSIONS: Our findings extend previous data on the impact of obesity on cardiac structure by showing that this phenotype is strongly associated with biventricular hypertrophy.