Left ventricular hypertrophy in hypertensive obese women.

OBJECTIVE: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular and general mortality. Both arterial hypertension and obesity cause changes in structure and function of the left ventricle. Given the rising global epidemic of obesity, it is likely that adverse health consequences of excess adiposity will escalate in the future. The aim of this investigation was to assess the relation and predictive value of obesity on the occurrence of left ventricular hypertrophy in hypertensive middle-aged women.

METHODS AND RESULTS: Investigation was conducted on a sample of 64 middle-aged women, diagnosed with arterial hypertension and treated longer than 10 years in the absence of other chronic diseases or heart failure. Based on anthropometric parameters, 14 women (21.9%) had a body mass index (BMI) within the normal range, 17 (26.6%) were overweight, and 33 (52.5%) were obese. Left ventricular hypertrophy was assessed by electrocardiographic and echocardiographic criteria. The influence of anthropometric parameters on left ventricular hypertrophy and patterns in left ventricular geometry was assessed using multivariate regression analyses. The prevalence of LV hypertrophy was 7.1% among normal-weight hypertensive women, 41.2% among overweight and 66.7% among obese women. Compared to normal-weight women, overweight and obese hypertensive subjects had higher mean values of all ECG and echo parameters. The strong correlation between anthropometric and left ventricular parameters was observed. Multivariate analysis showed that percent of body fat (OR = 1.226; 95% CI 1.011-1.486) was the only independent predictor of left ventricular hypertrophy. Being overweight was identified as predictor for the development of eccentric LV hypertrophy (OR = 31.824; 95% CI 1.225-826.850), and for concentric left ventricular remodelling (OR = 20.755; 95% CI 1.119-385.029).

CONCLUSIONS: Heart abnormalities occurring in arterial hypertension in conjunction with overweight/obesity include left ventricular hypertrophy and structural changes in the left ventricle. These findings support weight control and the regulation of blood pressure for the prevention of left heart abnormalities.