In nonobese subjects with mild hypertension, insulin sensitivity was inversely related to left ventricular mass index (r = -0.43; P = 0.02) independently of 24-hour mean blood pressure.
Cross-Sectional (n=29)
Is insulin sensitivity related to left ventricular mass independently of blood pressure in nonobese subjects with borderline or mild hypertension?
Insulin sensitivity is associated with left ventricular mass independently of blood pressure in nonobese subjects with borderline or mild hypertension, suggesting it may be an important modulator of LV growth.
Effect estimate: r = -0.43 (SI), r = 0.47 (BP)
p-value: p=0.02 (SI), 0.01 (BP)
Because left ventricular (LV) mass (LVM) is a powerful predictor of future cardiovascular events, it is important to identify hemodynamic and nonhemodynamic factors that increase LVM. We studied the separate contribution to LVM of daily arterial blood pressure (BP) and insulin resistance in a consecutive series of 29 (mean ± sd age, 43 ± 13 yr) nonobese (body mass index, 24 ± 1.8 kg/m2), nondiabetic, glucose-tolerant subjects with untreated borderline or mild hypertension. The insulin sensitivity index (SI) was quantitatively determined from the frequently sampled iv glucose tolerance test. BP was characterized by ambulatory 24-h BP monitoring, and LVM index (LVMI) was determined by two-dimensional directed M-mode echocardiography. LVMI was directly related to 24-h mean BP (r = 0.47; P = 0.01). LMVI was also significantly related to SI (r = −0.43; P = 0.02). In this nonobese group, neither LVMI nor SI was related to body mass index or age. After adjustment for the influence of BP on LVMI, a significant relation remained between LVMI and SI (P 0.05). We conclude that in nonobese subjects with high normal BP, insulin sensitivity is related to LVM independently of BP and may be an important modulator of LV growth. In addition to a reduction of arterial BP, optimal prevention of LV hypertrophy in hypertensives may require improved insulin sensitivity.
Phillips et al. (Tue,) conducted a cross-sectional in untreated borderline or mild hypertension (n=29). Insulin sensitivity index (SI) and 24-h ambulatory blood pressure was evaluated on Left ventricular mass index (LVMI) (r = -0.43 (SI), r = 0.47 (BP), p=0.02 (SI), 0.01 (BP)). In nonobese subjects with mild hypertension, insulin sensitivity was inversely related to left ventricular mass index (r = -0.43; P = 0.02) independently of 24-hour mean blood pressure.