RELATIONSHIP BETWEEN OBESITY AND LEFT VENTRICULAR MASS IN CAUCASIAN HYPERTENSIVE SUBJECTS. DOES SEX MATTER?

Abstract

Objective The excess of adiposity affects the heart through haemodynamic and non haemodynamic mechanisms leading to left ventricular hypertrophy (LVH) and ultimately to heart failure. It has been been previously observed, in a large study performed in American Indians, that the impact of obesity on left ventricular mass (LVM) is greater in women than men, while the results of other investigations carried out in other ethnic groups have yielded conflicting results .The aim of our study was to evaluate the potential influence of gender on the relationships between obesity and LVM in Caucasian patients with essential hypertension (EHs) . Design and method We enrolled 724 subjects with EH (mean age 45 ± 12 years, 63 % men ) without cardiovascular complications. In all subjects the anthropometric indices (weight, height and waist circumference ) and the routine biochemical parameters were determined . Furthermore, all patients underwent a 24-h blood pressure monitoring and an echocardiogram. LVM was indexed for body surface area (LVMI ) and for height2.7 (LVMH2.7) . Results The univariate correlations of LVM , LVMI , LVMH2.7 with body mass index (BMI) and the comparison of Pearson coefficients between the two sexes, evaluated using the Fisher r-to-z transformation, are shown in the following table. The greatest strength of the association of obesity with LVM , LVMI , LVMH2.7 in women than in men was also confirmed (p always < 0.01) in multivariate models, where the interaction term “sex x obesity' was added along with multiple confounding factors. Similar results were obtained when as an index of adiposity waist circumference was used instead of BMI. Conclusions Our study seems to indicate that in Caucasians hypertensive subjects the impact of obesity and overweight on LVM is greater in women than in men.