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Insulin resistance influences the impact of hypertension on left ventricular diastolic dysfunction in a community sample.


ABSTRACT:

Background

Although obesity-associated metabolic abnormalities (insulin resistance-IR) may not play as marked a role in determining left ventricular (LV) diastolic dysfunction (DD) as hypertension, the impact of combinations of these risk factors on DD is unknown.

Hypothesis

We hypothesized that IR influences the impact of hypertension on DD.

Methods

In 704 randomly selected participants from a community sample with a high prevalence of hypertension (50.6%) and obesity (46.5%), we determined adiposity indices, IR from the homeostasis model (HOMA-IR) and LV diastolic function using standard echocardiographic techniques.

Results

HOMA-IR was independently associated with lateral wall e' and E/e' (P < 0.05 to P < 0.005) as well as a diagnosis of DD (P < 0.02). Importantly, however, an enhanced relationship between HOMA-IR and E/e' in hypertensives (n = 356, partial r = 0.15, P < 0.005) as compared to normotensives (n = 348, partial r = 0.02 P = 0.75) was noted. Consequently, as compared to normotensives, with adjustments for confounders, hypertension was independently associated with DD only in those with the highest tertile of HOMA-IR (odds ratio = 2.65, 95% confidence interval = 1.29-5.42, P < 0.01), while in those with the lowest tertile of HOMA-IR, hypertension failed to show a higher prevalence of DD (P = 0.22).

Conclusions

Insulin resistance enhances the impact of hypertension on LV DD. Thus, DD is more likely to occur with the combination of hypertension and IR.

SUBMITTER: Bamaiyi AJ 

PROVIDER: S-EPMC6712340 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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