Renal failure is associated with an increase in left ventricular hypertrophy (LVH) in Afro??”Caribbean hypertensive patients with Type 2 diabetes, a cross-sectional study reveals.

The research also shows that the major risk factors obesity and pulse pressure differ by level of renal function.

Afro??”Caribbean patients are at increased risk for both diabetes and hypertension, the leading causes of renal failure, compared with White populations. Furthermore, dialysis and hypertension increase LVH, a strong predictor of cardiovascular events.

To investigate the association between LVH and renal function, Anne Blanchet Deverly (University of Antilles and Guyane, Pointe-à-Pitre, Guadeloupe) and co-workers evaluated left ventricular structure and function in a population of Afro-Caribbean patients with both hypertension and Type 2 diabetes and varying levels of renal failure.

They divided the patients into three groups: normal renal function (150 patients); impaired renal function (183 patients); and those undergoing hemodialysis (75 patients).

Left ventricular mass was calculated and adjusted for height to give the left ventricular mass/height value. Left ventricular structure and function were assessed by echocardiography.

Reporting their results in the journal Diabetes and Metabolism, the authors say that left ventricular mass/height increased progressively with worsening renal function. Values were 49.0 g/m^2.7 in patients with normal renal function, 57.1 g/m^2.7 in patients with impaired renal function, and 59.8 g/m^2.7 in dialysis patients.

The prevalence of LVH was 48.3%, 64.8%, and 70.3%, respectively, in the three groups, and was more concentric than eccentric in those with impaired renal function.

The authors note that while use of antihypertensive treatments varied across the patient groups with calcium-channel blockers more often prescribed in patients with end-stage renal disease, this could not explain the observed differences in LVH.

In this study, factors associated with LVH differed according to renal function profile. Obesity was a risk factor for LVH in patients with normal and impaired renal function, but not in dialysis patients, whereas an increase in pulse pressure of 10 mmHg was a risk factor in patients with impaired renal function and in dialysis patients.

“Our results show that to reduce LVH in hypertensive diabetic patients, obesity and pulse pressure are the parameters that need to be particularly followed, as these are the risk factors for LVH in such a population,” conclude the authors.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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