Insulin sensitivity was inversely related to left ventricular wall thickness (r = -0.59, P < 0.0001), explaining 43% of its variation in patients with untreated hypertension.
Cross-Sectional (n=50)
Is left ventricular hypertrophy associated with insulin resistance in patients with untreated hypertension?
In patients with hypertension, left ventricular hypertrophy and diastolic dysfunction are strongly associated with insulin resistance, independent of blood pressure levels.
Effect estimate: r = -0.59
p-value: p=<0.0001
OBJECTIVE: To investigate whether left ventricular hypertrophy is associated with the insulin resistance syndrome. METHODS: Fifty patients with untreated hypertension were evaluated by recording office blood pressure during regular antihypertensive treatment and 24-h ambulatory blood pressure and office blood pressure after 4-6 weeks on placebo, echocardiography with M-mode measurements of left ventricular wall thickness and pulsed-wave Doppler measurements of mitral flow in diastole and the hyperinsulinaemic euglycaemic clamp, for determination of insulin sensitivity. RESULTS: The left ventricular wall thickness was found to be significantly related to blood pressure r = 0.44, P < 0.004 for 24-h ambulatory systolic blood pressure (SBP), fasting insulin level (r = 0.32, P < 0.03) and haematocrit level (r = 0.37, P < 0.009) and inversely related to insulin sensitivity (r = -0.59, P < 0.0001). Multiple regression analysis with these relationships together with confounding factors age, sex, body mass index and waist: hip ratio as independent variables showed insulin sensitivity to be the only significant variable, explaining 43% of the variation in left ventricular wall thickness, whereas 24-h ambulatory SBP explained a further 7%. Left ventricular diastolic filling, as evaluated by the mitral Doppler early: atrial ratio, was significantly correlated with insulin sensitivity (r = 0.42, P < 0.003) and inversely related to blood pressure (r = -0.41, P < 0.02 for 24-h ambulatory SBP), left ventricular wall thickness (r = -0.34, P < 0.02) and serum fibrinogen level (r = -0.63, P < 0.0001). However, multiple regression analysis showed that insulin sensitivity was more closely related to diastolic filling than to blood pressure or left ventricular wall thickness. CONCLUSION: The present study showed left ventricular wall thickness to be closely associated with insulin resistance. Because diastolic dysfunction of the left ventricle was also related to a decreased insulin sensitivity, these findings suggest that left ventricular hypertrophy and diastolic dysfunction are associated with the insulin resistance metabolic syndrome.
Lind et al. (Sat,) conducted a cross-sectional in untreated hypertension (n=50). Insulin sensitivity was evaluated on Left ventricular wall thickness (r = -0.59, p=<0.0001). Insulin sensitivity was inversely related to left ventricular wall thickness (r = -0.59, P < 0.0001), explaining 43% of its variation in patients with untreated hypertension.