Influence of Low High-Density Lipoprotein Cholesterol on Arterial Stiffening and Left Ventricular Diastolic Dysfunction in Essential Hypertension

Introduction: Hypertension (HTN) is a global public health problem with one fourth adults worldwide estimated to have high blood pressure (BP)1 The incidence of hypertension continues to increase in all developed and developing societies as the population grows older and more obese. The Framingham Study and other epidemiological surgeys have clearly defined HTN as an important cause of morbidity and mortality. The aim of this study was to determine the spot urine Microalbuminuria as a marker of preclinical cardiac structural and functional changes in the form of left ventricular diastolic dysfunction in newly diagnosed and never treated essential hypertensive subjects. Methods: A cross sectional study was used for those patients who were attended outpatient clinic of MCVTC with diagnosis of newly diagnosed and never treated hypertension over a period of October 2011 to November 2012. Results: A total of 130 essential hypertensive patients underwent for spot urine for microalbuminuria estimation and Echocardiography for evaluation of left ventricular diastolic function. Among 56 (43.1%) urine samples showed negative test [(Microalbuminuria -); ( UACR 30 mg/Gm)] and those 74 (56.9%) samples revealed positive test [(Microalbuminuria+); (UACR 30 to 300 mg/Gm)]. Patients with microalbuminuria positive was found to have more left ventricular diastolic dysfunction than those who were negative for Microalbuminuria. Conclusion: Microalbuminuria was found to have early preclinical marker of myocardial dysfunction in the form of left ventricular diastolic dysfunction in new and never treated essential hypertension. DOI: http://dx.doi.org/10.2126/joim.v35i1.8890 Journal of Institute of Medicine, April, 2013; 35:3-8

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Left ventricular diastolic dysfunction is accompanied by increased aortic stiffness in the early stages of essential hypertension: a TDI approach

Journal of Hypertension ◽

10.1097/01.hjh.0000174394.57644.69 ◽

2005 ◽

Vol 23 (9) ◽

pp. 1745-1750 ◽

Cited By ~ 58

Author(s):

Costas Tsioufis ◽

Dimitris Chatzis ◽

Kyriakos Dimitriadis ◽

Pavlos Stougianos ◽

Apostolis Kakavas ◽

...

Keyword(s):

Essential Hypertension ◽

Diastolic Dysfunction ◽

Aortic Stiffness ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Early Stages ◽

Ventricular Diastolic Dysfunction

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High-Density Lipoprotein Cholesterol and Left Ventricular Mass Index in Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686080802800611 ◽

2008 ◽

Vol 28 (6) ◽

pp. 611-616 ◽

Cited By ~ 6

Author(s):

Ryota Ikee ◽

Yoshifumi Hamasaki ◽

Machiko Oka ◽

Kyoko Maesato ◽

Tsutomu Mano ◽

...

Keyword(s):

Peritoneal Dialysis ◽

High Density Lipoprotein ◽

Left Ventricular Mass ◽

High Density Lipoprotein Cholesterol ◽

Left Ventricular Mass Index ◽

Density Lipoprotein ◽

Left Ventricular ◽

High Density ◽

Lipoprotein Cholesterol ◽

Ventricular Mass Index

Objective The prevalence of left ventricular hypertrophy (LVH) reaches 75% in patients with end-stage renal disease. In patients on peritoneal dialysis (PD), some factors, such as hypertension, volume overload, serum albumin, and residual renal function, have been reported to be related to LVH. Dyslipidemia often occurs in PD but it remains unclear whether dyslipidemia is related to LVH. We investigated the relationship between clinical parameters, including lipid profile, and left ventricular mass index (LVMI). Methods In this cross-sectional study, 34 patients undergoing PD for more than 1 year without combined therapy with hemodialysis were included. We recorded the patients’ clinical data and related those parameters with LVMI as evaluated by echocardiography. Results The patients included 23 males and 11 females (age 62.2 ± 12.1 years, duration on PD 31.6 ± 15.6 months). Mean LVMI was 142 ± 37 g/m2. In univariate analysis, urine volume ( r = -0.493, p = 0.003), total cholesterol ( r = -0.418, p = 0.01), high-density lipoprotein cholesterol (HDL-C; r = -0.374, p = 0.02), and human atrial natriuretic peptide (hANP; r = 0.600, p < 0.001) significantly correlated with LVMI. Stepwise multiple regression analysis showed that hANP (β= 0.524, p = 0.001) and HDL-C (β= -0.422, p = 0.007) were independently associated with LVMI ( r2 = 0.32). Conclusion Strict volume control and salt restriction is essential for prevention of LVH. The role of HDL-C in the development of LVH in PD patients remains to be determined.

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