Objectives To investigate the relationship between small reductions in
estimated glomerular filtration rate (eGFR) and cardiac structure and
function in patients with essential hypertension. Methods The study
group included 565 patients with essential hypertensive. eGFR was
calculated by EPI equation and cardiac structure and function were
assessed using echocardiography. The participants were divided into
three groups: eGFR ≥90 mL/min /1.73 m2, 60-89 mL/min/1.73 m2, and 30-59
mL/min /1.73 m2. Pearson correlation analysis and multiple stepwise
linear regression analysis were performed to evaluate associations
between eGFR and echocardiogram parameters. Results Compared with
patients with eGFR ≥ 90 mL/min/ 1.73 m2, those with eGFR 60-89 mL/min/
1.73 m2 and 30-59 mL/min/ 1.73 m2 had higher left ventricular
end-diastolic diameter (LVEDD) (p=0.019), mitral valve E wave (p=0.004),
left atrial diameter (LAD) (p=0.001), right atrial diameter (RAD)
(p=0.001), right ventricular diameter (RVD) (p=0.001) and lower left
ventricular ejection fraction (LVEF) (p=0.01). After further adjustment
for traditional cardiovascular risk factors including systolic and
diastolic blood pressure, BMI, diabetes, dyslipidemia and smoking, eGFR
was still associated with LVEF (p＜0.001), LAD (p＜0.001) and RAD
(p=0.003). Conclusion Among patients with essential hypertension, even
mildly reduced renal function is independently associated with greater
cardiac remodeling, indicated by left atrial and right atrial
enlargement, and worse left ventricular systolic function.
Effects of ACE Inhibitors versus Calcium Antagonists on Left Ventricular Morphology and Function in Patients with Essential Hypertension.