Metabolic syndrome is associated with left ventricular dilatation in primary hypertension

Abstract

Metabolic syndrome (MS) has been shown to predict cardiovascular events in hypertension. Recently, a new four-group left ventricular (LV) hypertrophy classification based on both LV dilatation and concentricity was proposed. This classification has been shown to provide a more accurate prediction of cardiovascular events, suggesting that the presence of LV dilatation may add prognostic information. We investigated the relationship between MS and the new classification of LV geometry in patients with primary hypertension. A total of 372 untreated hypertensive patients were studied. Four different patterns of LV hypertrophy (eccentric nondilated, eccentric dilated, concentric nondilated and concentric dilated hypertrophy) were identified by echocardiography. A modified National Cholesterol Education Program definition for MS was used, with body mass index replacing waist circumference. The overall prevalence of MS and LV hypertrophy (LVH) was 29% and 61%, respectively. Patients with MS showed a higher prevalence of LVH (P=0.0281) and dilated LV geometries, namely eccentric dilated and concentric dilated hypertrophy (P=0.0075). Moreover, patients with MS showed higher LV end-diastolic volume (P=0.0005) and prevalence of increased LV end-diastolic volume (P=0.0068). The prevalence of LV chamber dilatation increased progressively with the number of components of MS (P=0.0191). Logistic regression analysis showed that the presence of MS entails a three times higher risk of having LV chamber dilatation even after adjusting for several potential confounding factors. MS is associated with LV dilatation in hypertension. These findings may, in part, explain the unfavourable prognosis observed in patients with MS.

What Is the Effect of Metabolic Syndrome without Hypertension on Left Ventricular Hypertrophy?

“…The effect of MetS on LV geometry is not limited to the development of concentric LVH. Ratto et al have found a three times higher risk of developing LV chamber dilatation in hypertensive patients with MetS even after adjusting for other factors.…”

“…The LV Hypertrophy is an important and independent risk factor for cardiovascular events . So, it is an important therapeutic endpoint in hypertensive patients to prevent and/or to reduce LVH …”

“…2 So, it is an important therapeutic endpoint in hypertensive patients to prevent and/or to reduce LVH. 3 Although LV overload is the main factor responsible for LVH in hypertensive patients, LVH does not occur in all hypertensive patients. 4 Other factors may have a role in increasing LV mass in hypertensive patients such as genetic, 5 environmental, 6 and metabolic factors.…”

“…8 Previous studies have shown the strong association between MetS and increased LV mass in hypertensive patients. 3,9,10 However, the relation between LVH and MetS in the absence of hypertension has not been studied.…”

Hypertension and non‐alcoholic fatty liver disease proven by transient elastography

“…It is a clustering of cardiovascular risk factors, including insulin resistance, abdominal obesity, dyslipidemia, and hypertension . Intensive studies have established that metabolic syndrome is closely linked to hypertension . Recent studies have found that metabolic syndrome and its components independently predict the risk of NAFLD .…”