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Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects.

Abstract
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.
AuthorsR A Phillips, L R Krakoff, A Dunaif, D T Finegood, R Gorlin, S Shimabukuro
JournalThe Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 83 Issue 12 Pg. 4284-8 (Dec 1998) ISSN: 0021-972X [Print] United States
PMID9851765 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Topics
  • Adolescent
  • Adult
  • Aged
  • Blood Pressure (physiology)
  • Echocardiography
  • Female
  • Heart Ventricles
  • Humans
  • Hypertension (diagnostic imaging, physiopathology)
  • Insulin Resistance (physiology)
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Reference Values

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