Abstract-Several trials have suggested that insulin-like growth factor-1 (IGF-1) may have a pathophysiological role in the development of arterial essential hypertension. To verify the possible association of IGF-1 with left ventricular morphological and functional echocardiographic parameters in hypertension, we studied 40 male patients with newly diagnosed hypertension and 15 normotensive control subjects. Doppler echocardiography was performed and circulating free IGF-1 levels were determined in all subjects. Circulating free IGF-1 levels were higher in hypertensives than in control subjects (PϽ0.01). A significant inverse correlation was observed between free IGF-1 and isovolumic relaxation time in the overall population (rϭϪ0.37, PϽ0.01) and in hypertensives (rϭϪ0.57, PϽ0.0001), whereas this relation disappears in normotensives. These results were confirmed by multivariate analysis. The present study confirms that arterial essential hypertension represents a clinical condition associated with an increased synthesis of IGF-1. The observation of an inverse, independent association between free IGF-1 and isovolumic relaxation time suggests 2 alternative hypotheses: a possible beneficial effect of IGF-1 to diastolic relaxation or a resistance to IGF-1 in hypertension. (Hypertension. 2001;38:840-845.)Key Words: insulin growth factor Ⅲ hypertension, arterial Ⅲ echocardiography Ⅲ diastole Ⅲ relaxation A rterial hypertension, a major risk factor for stroke and myocardial infarction, is often complicated by left ventricular (LV) hypertrophy and abnormalities of LV function. In particular, LV diastolic dysfunction is an early sign of hypertensive heart disease. 1 It is now accepted that several humoral factors (vasoactive substances, hormones, growth factors, and cytokines) participate directly in the development of end-organ damage and metabolic alterations that occur in arterial essential hypertension. Recent reports have underscored the potential role of insulin in the development of cardiac damage, 2-4 and a possible influence of insulin-like growth factor-1 (IGF-1) has been supposed. 4,5 IGF-1 belongs to a family of single-chain polypeptides with structural homology to proinsulin. 6 Circulating IGF-1 is synthesized primarily by the liver under the control of growth hormone (GH). 7 However, IGF-1 can be synthesized by many other organs, including heart, and can act as an autocrine or a paracrine factor. 8 IGF-1 is a growth factor for cellular proliferation and differentiation, and it exerts both inotropic and growth effects in the heart. 9,10 The earliest interest in the relationship between the GH/IGF-1 axis and the cardiovascular system stemmed from the clinical and epidemiological observation that patients with acromegaly and high levels of GH and IGF-1 have an increased propensity to develop cardiovascular complications. 11-13 Later, in vitro and in vivo studies demonstrated that IGF-1 induces hypertrophy of cultured ventricular myocytes and participates in the development of LV hypertrophy. 10,14 The aim of ...