A study of the influence of insulin resistance on left ventricular mass in hypertensive patients.

ABSTRACT

OBJECTIVES: To study the influence of insulin resistance on the left ventricular mass in hypertensive subjects. MATERIAL AND METHODS: Thirty patients having uncomplicated essential hypertension were included in the study. Post-oral glucose load serum insulin level (2 hrs) was determined and this was used as a marker for insulin resistance. Two D-echocardiography was performed and left ventricular mass and left ventricular mass index were calculated. RESULT: Out of the 30 patients 18 were males and 12 were females. Eight were obese while the remaining 22 were non-obese. The patients were 27 to 70 years old. The mean age, height and weight were 54.83 +/- 9.46 years, 159.07 +/- 8.81 cm and 58.38 +/- 11.03 kg, respectively. The post oral glucose load serum insulin levels in the study ranged from 57.65 to 210.81 microU/ml. The left ventricular mass and left ventricular mass index ranged from 42.58 to 310.8 g (mean 196.60 +/- 65.13 g) and 42.74 to 185.59 g/m2 (mean 118.71 +/- 37.75 g/m2), respectively. The correlation coefficient ('r' value) between post oral glucose load serum insulin levels and left ventricular mass and left ventricular mass index were calculated. CONCLUSION: A strong positive correlation was observed between the post oral glucose load serum insulin levels and left ventricular mass ('r' = +0.750). A strong positive correlation between post oral glucose load serum insulin levels and left ventricular mass index ('r' = +0.757) was also observed. These correlations were found to be statistically highly significant (p < 0.01). This association was demonstrated independently of age, anthropometric measurements, systolic and diastolic blood pressure levels. Thus, in patients with essential hypertension, hyperinsulinemia (insulin resistance) has a role in promoting left ventricular hypertrophy.