Left ventricular mass in offspring of hypertensive parents: does it predict the future?

摘要

OBJECTIVE: to determine effect ofparental hypertension on left ventricular mass (LVM) in normotensive off spring.PARTICIPANTS AND METHODS: Echocardiography was performed in 45 normotensive off spring of hypertensive parent. These subjects were compared with 55 normotensive off spring of normotensive parents.RESULTS: 100 subjects were studied. They were divided into 2 groups, Hypertensive parental group and non Hypertensive parental group. Subjects of both the group were weight, height, body surface area (BSA) and body mass index (BMI) matched. While systolic blood pressure, diastolic blood pressure, mean arterial pressure and left ventricular mass (LVM) were higher in the hypertensive parental group as compared to non hypertensive parental group. The left ventricular mass index (LVMI) was higher in the study group and the difference was statistically significant. On correlation of anthropometric measurements and blood pressure with LV mass, in the non hypertensive parental group LVM had significant correlation with Weight (r=0.45, p=0.000, S) and BMI (r=0.41, p=0.002). While in hypertensive parental group LVM had significant correlation with Weight (r=0.38, p=0.008, S), BMI (r=0.35, p=0.016, S), BSA (r=0.36, p=0.013, S), SBP (r=0.36, p=0.014, S) and MAP (r=0.29, p=0.046, S).CONCLUSION: LV mass depends on variables like weight, BMI, BSA, SBP and MAP. There is a genetic predisposition to increased LV mass in children with parental hypertension and it could be more significant in the transmission of genetic susceptibility to increased LVM. The results highlight the need for further study in this direction. Introduction Left ventricular hypertrophy (LVH), defined either by electrocardiogram or echocardiography, is a potent independent risk factor for coronary heart disease (CHD) roughly doubling the risk of cardiovascular death in both men and women. LVH is the most powerful of any of the traditional risk factors in predicting not only death or myocardial infarction (MI) but also stroke, heart failure (HF), and other cardiovascular (CV) endpoints. Longitudinal epidemiological studies have shown the utility of different traditional risk factors measured from childhood to adulthood in predicting sub clinical CV changes in adults. Among the sub clinical measures, left ventricular mass (LVM), assessed by 2D M-mode echocardiography, is recognized as an important and powerful predictor of CV morbidity and mortality, independent of other traditional risk factors.Estimation of left ventricular mass by Echocardiography offers PROGNOSTIC INFORMATION beyond that provided by the evaluation of traditional cardiovascular risk factors. An increase in LVM predicts a higher incidence of clinical events including death, attributable to cardiovascular diseases.The study was therefore carried out to detect the prevalence of major cardiovascular risk factor i.e. LVM in a healthy young population before the occurrence of actual manifestations of clinical CAD and CHF and to identify candidates who might require early intervention to reduce their risk of future cardiovascular events. Participants And Methods This study was conducted in department of Medicine in Jawaharlal Nehru Medical College and associated A.V.B.R. Hospital of DMIMS university, Wardha. 100 randomly selected, apparently healthy, normotensive male students in the age group of 19 to 25 years were studied. Definite exclusion criteria was established as follows.Exclusion Criteria Persistent blood pressure ≥ 140/90 mm Hg. Current use of cardio active drug. Any cardiopulmonary disease. Any organic murmur. Any renal lump or renal bruit. Echocardiography showing evidence of any structural heart disease. Poor echocardiographic window The subjects were examined for,1. Weight in kilograms (kg)2. Height in meters (m)3. Blood pressure in mmHgBody mass index (BMI) was calculated by the Quetelet formulaBMI = Weight (kg) / Height (m2)Body surface area was calculated by the Mosteller formula.Body surfac