Creatinine and insulin predict cardiac mass in drug-naïve hypertensive patients

Abstract Background Blood pressure (BP) affects hypertensive left ventricular mass (LVM), explaining 10–25% of its variation. Thus, it is plausible that other factors operate in this process. Reduced kidney function is associated with increased LVM. Methods We enrolled 1000 untreated hypertensives w...

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Bibliographic Details
Published in:International journal of cardiology 2013-07, Vol.167 (2), p.519-524
Main Authors: Miceli, Sofia, Maio, Raffaele, Perticone, Maria, Tripepi, Giovanni, Sciacqua, Angela, Mazzaferro, Deborah, Sesti, Giorgio, Perticone, Francesco
Format: Article
Language:English
Subjects:
Adult
Aged
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Biomarkers - blood
Blood and lymphatic vessels
Cardiac mass
Cardiology. Vascular system
Cardiovascular
Creatinine
Creatinine - blood
Cross-Sectional Studies
Female
Heart
Humans
Hypertension
Hypertension - blood
Hypertension - diagnosis
Hypertension - epidemiology
Hypertrophy, Left Ventricular - blood
Hypertrophy, Left Ventricular - diagnosis
Hypertrophy, Left Ventricular - epidemiology
Insulin
Insulin - blood
Male
Medical sciences
Middle Aged
Predictive Value of Tests
Risk Factors
Young Adult
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Summary:Abstract Background Blood pressure (BP) affects hypertensive left ventricular mass (LVM), explaining 10–25% of its variation. Thus, it is plausible that other factors operate in this process. Reduced kidney function is associated with increased LVM. Methods We enrolled 1000 untreated hypertensives with serum creatinine ≤ 1.5 mg/dL and without proteinuria. BP was measured by standard sphygmomanometer. LVM was calculated with the Devereux formula and indexed by body surface area (LVMI). Anthropometric and the following laboratory parameters were measured: plasma glucose, serum insulin, cholesterol, triglyceride, creatinine and e-GFR (CKD-EPI equation). Results On univariate analysis, both insulin (r = 0.44, P < 0.0001) and creatinine (r = 0.37, P < 0.001) were directly related to LVMI. In multivariate regression analysis insulin resulted the first factor in rank explaining the variability in LVMI (semipartial r = 0.34,P < 0.001), followed by creatinine. Fasting insulin interacts with creatinine in explaining LVM variability: 0.1 mg/dL increase in creatinine produces an increase of 8.1 g/m2 in LVMI in patients with higher plasma insulin (upper quartiles). Conclusions Independently of other risk factors, fasting insulin and serum creatinine contribute to explain LVM development in hypertensives with preserved renal function; insulin interacts with creatinine in explaining LVM variability in these patients.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2012.01.077