Left and right ventricular structural changes in obese hypertensives

Figures & data

Table I. Clinical characteristics of the study population categorized in three groups by body mass index (BMI).

Variables	Group I, BMI < 25 kg/m^2	Group I, BMI 25–29.9 kg/m^2	Group III, BMI ≥ 30 kg/m^2	p
n	129	154	57
Age (years)	58.4±12.9	59.4±11.8	55.8±11.8	NS
Male gender (%)	54.8	65.6	67.2	NS
Abdominal circ. (cm)	85.5±8.6	96.6±6.6	107.1±7.7^**	0.001
Clinic BP (mmHg)	138±14/87±9	139±12/88±10	140±15/89±9	NS
Clinic HR (beats/min)	65.8±8.8	66.8±10.1	68.5±10.4	NS
Duration of HTN (years)	8.6±7.5	8.7±6.9	11.1±9.5	NS
Sokolow‐Lyon (mV)	19.9±5.9	20.0±5.6	18.8±6.0	NS
Blood glucose (mmol/l)	5.37±0.85	5.73±1.49	6.54±1.98^**	0.005
T. Cholesterol (mmol/l)	5.65±1.0	5.68±0.93	5.42±0.92	NS
HDL‐cholest (mmol/l)	1.60±0.43	1.46±0.39	1.36±0.41^§	0.002
LDL-cholest (mmol/l)	3.51±0.92	3.55±0.88	3.34±0.77	NS
Triglycerides (mmol/l)	1.29±0.57	1.57±1.15	1.73±1.14^*	0.03
Creatinine (μmol/l)	90.0±19.4	91.9±18.5	91.9±31.8	NS
Uric acid (μmol/l)	315.2±71.4	333.1±83.3	350.9±83.3^§	0.02
DM (%)	6.6	10.3	21.3^§	0.01
Met. syndrome (%)	27.4	47.0	81.2^**	0.01
Smokers (%)	18.0	11.9	12.7	NS
Multiple therapy (%)	26.6	23.7	41.8^*	0.01

Data are shown as means±SD or %. BP, blood pressure; HR, heart rate; HTN, hypertension; HDL, high‐density lipoprotein; LDL, low‐density lipoprotein; DM, diabetes mellitus; multiple therapy=three or more antihypertensive drugs. ^*p<0.05, ^**p<0.01, III vs II and I; ^§p<0.05 III vs I.

Table II. Echo‐Doppler parameters of the study population categorized in three groups by body mass index (BMI)

Variables	Group I, BMI<25 kg/m^2	Group II, BMI 25–29.9 kg/m^2	Group III, BMI≥30 kg/m^2	p
n	129	154	57
LVIDd (mm)	47.2±3.9	49.7±3.3	49.6±3.8^§	0.001
LVIDs (mm)	25.9±4.2	27.7±3.6	27.7±3.9^§	<0.05
IVSTd (mm)	9.8±1.3	10.4±1.1	11.0±1.5^**	0.001
PWTd (mm)	8.7±0.9	9.1±0.8	9.5±1.2^**	0.01
LVRWT (mm)	0.39±0.04	0.39±0.04	0.41±0.06^§	0.01
LA long axis (mm)	45.0±4.2	47.8±4.4	49.2±4.4^**	0.001
LA short axis (mm)	35.8±4.8	36.9±4.3	37.0±4.3	NS
LV mass (g)	175.1±44.1	204.5±38.7	219.6±61.2^**	0.003
LV mass index (g/h^2.7)	42.0±9.0	48.2±7.9	53.5±14.1^§	0.0002
mFS (%)	19.9±2.2	19.7±2.1	19.0±2.4	NS
(E/A)M ratio	1.07±0.36	1.04±036	0.99±0.35	NS
DTm (ms)	223.2±52.6	222.7±50.9	219.6±55.4	NS
RVDd outflow (mm)	26.1±4.2	26.9±3.7	28.2±3.8	NS
RVTd outflow (mm)	5.2±1.1	5.4±0.9	5.8±0.9^§	0.04
RVDd subcostal (mm)	30.4±4.3	31.3±4.0	33.0±4.5	0.008
RVTd subcostal (mm)	6.6±1.3	7.0±1.2	7.3±1.1	NS
TAPSE (cm)	2.1±0.31	2.0±021	2.1±0.20	NS
(E/A)T ratio	1.35±0.36	1.29±0.33	1.17±0.33^*	0.005
RA long axis (mm)	44.2±3.9	45.8±3.8	45.2±4.6	NS
RA short axis (mm)	34.0±4.7	34.5±4.7	34.6±4.9	NS
DTt (msec)	211.4±57.6	225.4±62.9	243.2±52.0^*	0.005

LVIDd, left ventricular internal diastolic diameter; LVIDs, left ventricular internal systolic diameter; IVSTd, interventricular septum thickness in diastole; PWTd, posterior wall thickness in diastole; LA, left atrium; LVM, left ventricular mass; RWT, relative wall thickness; Em, early diastolic mitral flow; Am, late diastolic mitral flow; DT, deceleration time; RVDd, right ventricular diastolic diameter; RVTd, right ventricular diastolic thickness; Et, early diastolic tricuspid flow; At, late diastolic tricuspid flow; RA, right atrium; TAPSE, tricuspid annular plane systolic excursion. ^*p<0.05, ^**p<0.01, III vs II and I; ^§p<0.05 III vs I.

Figure 1. Prevalence rates of different cardiac phenotypes, normal ventricular geometry (N), isolated right ventricular hypertrophy (RVH), left ventricular hypertrophy (LVH), biventricular hypertrophy (BH) in essential hypertensives categorized according to body mass index (BMI).

Table III. Univariate and multivariate correlations between body mass index and clinical and echocardiographic variables.

	Univariate analysis		Multivariate analysis
Variables	r	p	β	p
Age	0.05	0.93	–	–
Clinic SBP	0.08	0.14	–	–
Clinic DBP	0.10	0.06	–	–
Clinic HR	0.10	0.06	–	–
Duration HTN	0.09	0.08	–	–
Sokolow -Lyon	–0.06	0.23	–	–
Plasma glucose	0.29	<0.0001	0.105	0.106
HDL-cholesterol	–0.28	<0.0001	–0.179	0.006
LDL‐cholesterol	0.06	0.46	–	–
Triglycerides	0.19	0.0006	0.51	0.437
Serum creatinine	0.10	0.06	–	–
Uric acid	0.20	0.002	0.098	0.108
LVM/h^2.7	0.44	<0.0001	0.324	<0.0001
LV‐RWT	0.19	0.0005	–0.103	0.199
(E/A)M	0.13	0.01	0.075	0.305
Mid‐wall shortening	0.17	0.002	–0.109	0.155
RVTd (outflow)	0.27	<0.0001	0.184	0.008
(E/A)T	0.23	<0.0001	–0.255	0.0004

See Table II for abbreviations.