Family history of hypertension influences left ventricular diastolic function during chronic antihypertensive therapy
| Autor: | Achille Venco, Andrea Maria Maresca, Francesco Solbiati, Anna Maria Grandi, E. Nicolini, Monica Gianni, Luigina Guasti, Emanuela Laurita, Chiara Marchesi |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty myocardial hypertrophy medicine.medical_treatment Diastole Blood Pressure Cardiomegaly Essential hypertension Electrocardiography Ventricular Dysfunction Left Insulin resistance Enalapril Heart Rate Internal medicine insulin resistance Angiotensin-converting enzyme inhibitors Internal Medicine Medicine Humans Genetic Predisposition to Disease Antihypertensive Agents business.industry Insulin diastolic function essential hypertension Glucose Tolerance Test Middle Aged medicine.disease Endocrinology Blood pressure Basal (medicine) Hypertension Cardiology Female business Body mass index medicine.drug |
| Popis: | Background Genetic factors play an important role in linking insulin resistance and hypertension, also influencing insulin sensitivity changes during antihypertensive treatment. This study was aimed to evaluate whether genetic predisposition to hypertension can also influence left ventricular (LV) changes during antihypertensive treatment. Methods We enrolled 36 never-treated hypertensives: 18 with both parents hypertensive (F+) and 18 with both parents normotensive (F−), matched for age, gender, and body mass index (BMI). The patients were evaluated twice, before and after 2.5 years of treatment with enalapril. At both evaluations the patients underwent: 24-h blood pressure (BP) monitoring, LV echocardiogram, and oral glucose tolerance test, with measurements of glucose and insulin levels. Results At basal evaluation the two groups were not different with regard to gender, age, BMI, 24-h BP, and fasting glucose; glucose metabolic clearance rate was significantly lower in F+. The LV mass index was similar between the groups, whereas diastolic parameters were significantly lower in F+. At second evaluation, 24-h BP and LV mass were decreased to the same extent in both groups; glucose metabolic clearance rate significantly increased in F− and remained unchanged in F+. The improvement of LV diastolic function, found in both group, was significantly greater in F−. Conclusions Genetic predisposition to hypertension, in addition to affecting insulin sensitivity, influences LV functional changes during antihypertensive treatment. Despite a similar extent of 24-h BP and LV mass decrease, F+ patients showed no changes in insulin sensitivity and a smaller improvement in LV diastolic function than F−. |
| Databáze: | OpenAIRE |
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