Glucose and insulin metabolism are important determinants of left ventricular mass in obese hypertensives.

BACKGROUND

Obesity and hypertension, the major modifiable clinical determinants of left ventricular mass, are both associated with a state of insulin resistance.

OBJECTIVE

To determine the relationships between glucose and insulin metabolism and left ventricular mass in a group of obese, nondiabetic, hypertensive people.

PATIENTS AND METHODS

Twenty-two obese, nondiabetic, hypertensive people (10 men), free of coronary or valvular heart disease, with normal left ventricular function were studied. The mean age was 55+/-12 years, body mass index 32.8+/-4.8 kg/m2, and systolic and diastolic blood pressures 149.0+/-11.0 mmHg and 98.0+/-4.0 mmHg, respectively. Left ventricular mass corrected for height (LVM/Ht) and glucose and insulin metabolism (3 h intravenous glucose tolerance test) were measured after a four- to six-week washout period of any antihypertensive medication.

RESULTS

The mean LVM/Ht was 119.5+/-11.9 kg/m. The following metabolic measures correlated with LVM/Ht in a univariate analysis: total insulin integration area (r=0.54, P=0.008); fasting insulin (r=0.43, P=0.04); insulin at 90 min (r=0.54, P=0.013); and peak glucose levels (r=0.51, P=0.013). Stepwise multivariate linear regression analysis showed that only total insulin integration area (P=0.005) and peak glucose levels (P=0.01) correlated with LVM/Ht.

CONCLUSION

In obese, nondiabetic, hypertensive people, left ventricular mass is associated with circulating glucose and insulin levels.