J Korean Diabetes Assoc.  2007 Mar;31(2):130-135. 10.4093/jkda.2007.31.2.130.

Waist Circumference May be More Important than Body Mass Index (BMI) in Determinants of Left Ventricular Mass in Korean Hypertensive Patients

Affiliations
  • 1Department of Internal Medicine, School of Medicine, Wonkwang University, Korea.
  • 2Department of Physiology, School of Medicine, Cheonbuk National University, Korea.

Abstract

BACKGROUND: In many studies, obesity is highly correlated with adverse coronary risk profile. Increased left ventricular (LV) mass is an independent risk factor for cardiovascular mortality and morbidity. Hypertension is an well known factor related with LV mass. Obesity also is related with LV mass and commonly associated with hypertension. However, few data are available concerning the relations of LV mass to central obesity, especially in Korean hypertensive patients. So, this study was to evaluate the significance of waist circumference in determinants of LV mass in Korean hypertensive patients.
METHODS
A total of 74 hypertensive [40 women, 34 men; mean age, 62.5 years; mean body mass index (BMI), 25.0 kg/m2, 17 with type 2 diabetes] patients without prevalent cardiovascular disease were studied. Echocardiographic LV septal thickness, LV posterior wall thickness, LV dimension and LV mass were analysed.
RESULTS
LV mass, diastolic left ventricular internal dimension and epicardial fat thickness were larger in men than in female. LV mass was larger in obese patients defined by body mass index and also in central obese patients defined by waist circumference. LV mass was correlated with sex, body mass index, waist circumference, diastolic left ventricular internal dimension, left ventricular posterior wall thickness and interventricular septal thickness. After controlling for age, sex and body mass index, waist circumference was correlated with LV posterior wall thickness and LV mass.
CONCLUSION
Waist circumference may be more important than BMI in determinants of left ventricular mass in Korean hypertensive patients.

Keyword

Hypertension; LV mass; Obesity; Waist circumference

MeSH Terms

Body Mass Index*
Cardiovascular Diseases
Echocardiography
Female
Humans
Hypertension
Male
Mortality
Obesity
Obesity, Abdominal
Risk Factors
Waist Circumference*

Figure

  • Fig. 1 Left ventricular mass in normal (BMI < 23 kg/m2) and obese (BMI > 25 kg/m2) hypertensive patients.

  • Fig. 2 Comparison of left ventricular mass between non-central obese and central obese hypertensive patients.


Reference

1. Koren MJ, Devereux RB, Casale PN. Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1990. 115:345–352.
2. Levy D, Garrison RJ, Savage DD. Prognostic implications of echocardiographically determined left ventricular mass in Framingham Heart Study. N Engl J Med. 1990. 322:1561–1566.
3. Kannel WB. Left ventricular hypertrophy as a risk factor in arterial hypertension. Eur Heart J. 1992. 13:82–88.
4. Brilla CG. Renin-angiotensin system mediated mechanisms: cardioreparation and cardioprotection. Heart. 2000. 84:i18–i19.
5. Nakajima T, Fujioka S, Tokunaga K, Hirobe K, Matsuzawa Y, Tarui S. Noninvasive study of left ventricular performance in obese patients; influence of duration of obesity. Circulation. 1985. 71:481–486.
6. Messerli FH, Sundgaard Riise ED, Dreslinski GR, Ventura HO, Digman W, Frohlich ED, Dunn FG. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med. 1983. 99:757–761.
7. Lauer MS, Anderson KM, Kannel WB, Levy D. The impact of obesity on left ventricular mass and geometry: the Framingham Heart Study. JAMA. 1991. 266:231–236.
8. Vetta F, Cicconetti P, Ronzoni S, Rizzo V, Palleschi L, Canarile G, Lupattelli MR, Migliori M, Morelli S, Marigliano V. Hyperinsulinemia, regional adipose tissue distribution and left ventricular mass in normotensive, elderly, obese subjects. Eur Heart J. 1998. 19:326–331.
9. World Health Organization western pacific region. The Asia-Pacific perspective: redefining obesity and its treatment. 2000.
10. Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiol Rev. 1994. 74:761–811.
11. Montague C, O'Rahilly S. The perils of portliness: cause and consequence of visceral adiposity. Diabetes. 2000. 49:883–888.
12. Krotkiewski M, Bjomtorp P, Sjostrom L, Smith U. Impact of obesity on metabolism in men and women: importance of regional adipose tissue distribution. J Clin Invest. 1983. 72:1150–1162.
13. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of partipants in the population study of women in Gothenburg, Sweeden. Br Med J. 1984. 289:1257–1261.
14. Kannel WB, Cupples LA, Ramaswami R, Stokes J, Kreger BE, Higgins M. Regional obesity and risk of cardiovascular disease. J Clin Epidemiol. 1991. 44:183–190.
15. Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW. Relation of body fat distribution to metabolic complication of obesity. J Clin Endocrinol Metab. 1982. 54:254–260.
16. Frohlich ED. Potential mechanism explaining the risk of left ventricular hypertrophy. Am J Cardiol. 1987. 59:91A–97A.
17. Kuch B, Hense HW, Gneiting B, Doring A, Muscholl M, Brockel U, Schunkert H. Body composition and prevalence of left ventricular hypertrophy. Circulation. 2000. 102:405–410.
19. Sasson Z, Rasooly Y, Bhesania T, Rassoly I. Insulin resistance is an important determinant of left ventricular mass in the obese. Circulation. 1993. 88:1431–1436.
20. Rheeder P, Stolk RP, Mosterd A, Pols HA, Hofman A, Grobbee DE. Insulin resistance syndrome and left ventricular mass in an elderly population. Am J Cardiol. 1999. 84:233–236.
21. Kuch B, Hense HW, Gneiting B, Doring A, Muscholl M, Brockel U, Schunkert H. Body composition and prevalence of left ventricular hypertrophy. Circulation. 2000. 102:405–410.
22. Galvan AQ, Galetta F, Natali A, Muscelli E, Sironi AM, Cini G, Camastra S, Ferrannini E. Insulin resistance and hyperinsulinemia: no independent relation to left ventricular mass in humans. Circulation. 2000. 102:2233–2238.
23. Park YW, Allison DB, Heymsfield SB, Gallagher D. Larger amount of visceral adipose tissue in Asian Americans. Obes Res. 2001. 9:381–387.
24. Sasson Z, Rasooly y, Bhesania T, Rasooly I. Insulin Resistance Is an Important Determinant of Left Ventricular Mass in the Obese. Circulation. 1993. 88:1431–1436.
25. Greenfield JR, Campbell LV. Insulin Resistance and Obesity. Clinics in Dermatology Y. 2004. 22:289–295.
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