Key result
Combined endothelial and mild renal dysfunction was significantly associated with increased severity of left ventricular hypertrophy in hypertensive patients (OR 4.629; 95% CI 1.592-13.458; P=0.005).
Why the study?
Does the combination of endothelial dysfunction and mild renal dysfunction associate with increased severity of left ventricular hypertrophy in hypertensive patients?
Observational (n=317)
Does the combination of endothelial dysfunction and mild renal dysfunction associate with increased severity of left ventricular hypertrophy in hypertensive patients?
Odds Ratio: 4.629 (95% CI 1.592–13.458)
p-value: p=0.005
The combination of endothelial dysfunction and mild renal impairment is strongly associated with increased severity of left ventricular hypertrophy in hypertensive patients.
May flag higher LVH risk among hypertensives; hypothesis-generating and requires longitudinal confirmation.
BACKGROUND: The association between impaired renal function and increase left ventricular mass was shown to be related to increase in arterial stiffness, which indicates that vascular homeostasis and remodeling may impact the left ventricular hypertrophy (LVH) in patients with renal dysfunction. METHODS: We measured the peripheral arterial reactive hyperemia index (RHI) and estimated glomerular filtration rate (eGFR) in 317 hypertensive patients comprising 115 normal RHI (RHI > 1.67) and normal eGFR (eGFR ≥ 90ml/min per 1.73 m(2)), 136 low RHI (RHI ≤ 1.67), 27 low eGFR (60 ≤ eGFR < 90ml/min per 1.73 m(2)) and 39 low RHI combined with low eGFR. RESULTS: Multivariate logistic regression analysis identified lg RHI (odds ratio (OR): 0.001, 95% confidence interval (CI): 10(-6) to 0.426, P = 0.024) and lg eGFR (OR: 0.009, 95% CI: 10(-4) to 0.414, P = 0.016) as independent factors correlated with LVH respectively in hypertensive patients. Compared with normal RHI and eGFR patients, the extent of LVH in patients with either low RHI (OR: 1.224 95% CI: 0.451 to 3.327, P = 0.691) or low eGFR (OR: 0.593 95% CI: 0.070 to 5.037, P = 0.632) did not significantly increase, while it increased significantly in patients with low RHI combined with low eGFR (OR: 4.629 95% CI: 1.592 to 13.458, P = 0.005). CONCLUSIONS: The concurrence of endothelial and mild renal dysfunction was significantly associated with the severity of LVH in hypertensive patients.
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Cao et al. (2015) conducted an observational in Hypertension (n=317). Combined low reactive hyperemia index and low estimated glomerular filtration rate vs. Normal reactive hyperemia index and normal estimated glomerular filtration rate was evaluated on Severity of left ventricular hypertrophy (OR 4.629, 95% CI 1.592 to 13.458, p=0.005). Combined endothelial and mild renal dysfunction was significantly associated with increased severity of left ventricular hypertrophy in hypertensive patients (OR 4.629; 95% CI 1.592-13.458; P=0.005).
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