Left ventricular mass in hypertensive patients with mild-to-moderate reduction of renal function

Abstract

Aim: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular (CV) morbidity and mortality. The aim of our study was to evaluate the relationship between LV mass and mild-moderate renal dysfunction in a group of non-diabetic hypertensives, free of CV diseases, participating to the REDHY (REnal Dysfunction in HYpertension) Study. Methods: Patients with diabetes, body mass index (BMI) >35 kg/m2; secondary hypertension, cardiovascular (CV) diseases, GFR <30 ml/min/1.73 m2 were excluded. The final sample included 455 patients, who underwent echocardiographic examination and ambulatory blood pressure monitoring. Results: There was a significant trend for a stepwise increase in LV mass, indexed by both body surface area (LVMI) and height elevated to 2.7 (LVMH2.7), with the declining renal function, that remained statistically significant after correction for potential confounders. The prevalence of LVH, defined either as LVMI ≥ 125 g/m2 or as LVMH2.7≥ 51 g/m2.7, was higher in subjects with lower values of GFR than in those with normal renal function (p < 0.001 in both cases). The multiple regression analysis confirmed that the inverse association between GFR and LVM was independent of confounding factors. Conclusion: Our study confirms the high prevalence of LVH in patients with mild or moderate renal dysfunction. In the patients studied (all with GFR ≥ 30 ml/min/1.73 m2), the association between LVM and GFR was independent of potential confounders, including 24-hour BP load. Taking into account the negative prognostic impact of LVH, further studies focusing a more deepened comprehension of the mechanisms underlying the development of LVH in CKD patients are needed.