Skip to main content
SpringerLink
Log in

Prevalence of Left Ventricular Hypertrophy and Determinants of Left Ventricular Mass in Obese Women

  • Original Research Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

Background

Obesity is frequently associated with left ventricular hypertrophy (LVH), a condition leading to an increased cardiovascular risk.

Aim

The objective of this study was to evaluate the prevalence of LVH in a cohort of obese women, with a main focus on the anthropometric and clinical parameters that are associated with an increased left ventricular mass (LVM).

Methods

The study was performed in 166 obese female patients. LVM was measured by echocardiography. The influence of various parameters on LVM was assessed by multivariate analysis.

Results

The prevalence of LVH was drastically different depending on the type of indexed LVM, being 19.9% when the LVM was indexed for body surface area and 72.3% when indexed for height. Age, duration of obesity, weight, waist-to-hip ratio, pulse pressure and hypertension retained an independent direct correlation with the LVM, explaining 39.6% of the overall LVM variability. Among the parameters of the metabolic syndrome, the increase in blood pressure was the main determinant of increased LVM.

Conclusions

By using allometric indexation of LVM for height, the results of our study indicate a high prevalence of LVH in a cohort of obese women. Hypertension, pulse pressure, age, duration of obesity, bodyweight and fat distribution, expressed as waist-to-hip ratio, predict 40% of LVM variation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II
Fig. 1
Table III
Fig. 2
Table IV
Table V

Similar content being viewed by others

References

  1. Kelly T, Yang W, Chen CS, et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond) 2008; 32: 1431–7.

    Article  CAS  Google Scholar 

  2. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009; 122: 1106–14.

    CAS  Google Scholar 

  3. de Simone G, Wachtell K, Palmieri V, et al. Body build and risk of cardiovascular events in hypertension and left ventricular hypertrophy: the LIFE (Losartan Intervention For Endpoint reduction in hypertension) study. Circulation 2005; 111: 1924–31.

    Article  PubMed  Google Scholar 

  4. Prospective Studies Collaboration, Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373: 1083–96.

    Article  PubMed  Google Scholar 

  5. Wilson PW, D’Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002; 162: 1867–72.

    Article  PubMed  Google Scholar 

  6. Bogers RP, Bemelmans WJ, Hoogenveen RT, et al., for the BMI-CHD Collaboration Investigators. Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons. Arch Intern Med 2007; 167: 1720–8.

    Article  PubMed  Google Scholar 

  7. de Simone G, Devereux RB, Roman MJ, et al. Relation of obesity and gender to left ventricular hypertrophy in normotensive and hypertensive adults. Hypertension 1994; 23: 600–6.

    Article  PubMed  Google Scholar 

  8. Devereux RB, Wachtell K, Gerdts E, et al. Prognostic significance of left ventricular mass change during treatment of hypertension. JAMA 2004; 292: 2350–6.

    Article  PubMed  CAS  Google Scholar 

  9. de Simone G, Gottdiener JS, Chinali M, et al. Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study. Eur Heart J 2008; 29: 741–7.

    Article  PubMed  Google Scholar 

  10. Bombelli M, Facchetti R, Carugo S, et al. Left ventricular hypertrophy increases cardiovascular risk independently of in-office and out-of-office blood pressure values. J Hypertens 2009; 27: 2458–64.

    Article  PubMed  CAS  Google Scholar 

  11. Mancia G, Laurent S, Agabiti-Rosei E, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. Blood Press 2009; 18: 308–47.

    Article  PubMed  CAS  Google Scholar 

  12. Grassi G, Diez J. Obesity-related cardiac and vascular structural alterations: beyond blood pressure overload. J Hypertens 2009; 27: 1750–2.

    Article  PubMed  CAS  Google Scholar 

  13. Norton GR, Majane OH, Libhaber E, et al. The relationship between blood pressure and left ventricular mass index depends on an excess adiposity. J Hypertens 2009; 27: 1873–83.

    Article  PubMed  CAS  Google Scholar 

  14. Genuth S, Alberti KG, Bennett P, et al. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003; 26: 3160–7.

    Article  PubMed  Google Scholar 

  15. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–97

    Article  Google Scholar 

  16. de Simone G, Kizer JR, Chinali M, et al. Strong Heart Study Investigators. Normalization for body size and population-attributable risk of left ventricular hypertrophy: the Strong Heart Study. Am J Hypertens 2005; 18: 191–6.

    Article  PubMed  Google Scholar 

  17. Chirinos JA, Segers P, De Buyzere ML, et al. Left ventricular mass: allometric scaling, normative values, effect of obesity, and prognostic performance. Hypertension 2010; 56: 91–8.

    Article  PubMed  CAS  Google Scholar 

  18. de Simone G, Devereux RB. Method errors or unexplained biological information? Hypertension 2010; 56: e177–8

    Article  PubMed  Google Scholar 

  19. Mancia G, Bombelli M, Corrao G, et al. Metabolic syndrome in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study: daily life blood pressure, cardiac damage, and prognosis. Hypertension 2007; 49: 40–7.

    Article  PubMed  CAS  Google Scholar 

  20. de Simone G, Devereux RB, Chinali M, et al. Metabolic syndrome and left ventricular hypertrophy in the prediction of cardiovascular events: the Strong Heart Study. Nutr Metab Cardiovasc Dis 2009; 19: 98–104.

    Article  PubMed  Google Scholar 

  21. Redon J, Cifkova R, Laurent S, et al. Scientific Council of the European Society of Hypertension. The metabolic syndrome in hypertension: European Society of Hypertension position statement. J Hypertens 2008; 26: 1891–900.

    CAS  Google Scholar 

  22. Casiglia E, Tikhonoff V, Caffi S, et al. Menopause does not affect blood pressure and risk profile, and menopausal women do not become similar to men. J Hypertens 2008; 26: 1983–92.

    Article  PubMed  CAS  Google Scholar 

  23. Lieb W, Xanthakis V, Sullivan LM, et al. Longitudinal tracking of left ventricular mass over the adult life course: clinical correlates of short- and long-term change in the Framingham Offspring Study. Circulation 2009; 119: 3085–92.

    Article  PubMed  Google Scholar 

  24. de Simone G, Devereux RB, Palmieri V, et al., HyperGEN Study. Influence of fat-free mass on detection of appropriateness of left ventricular mass: the HyperGEN Study. J Hypertens 2003; 21: 1747–52.

    Article  PubMed  Google Scholar 

  25. Jennings G. Obesity and left ventricular hypertrophy: does my heart look big on this? J Hypertens 2010; 28: 2190–3.

    Article  PubMed  CAS  Google Scholar 

  26. Alpert MA, Lambert CR, Panayiotou H, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol 1995; 76: 1194–7.

    Article  PubMed  CAS  Google Scholar 

  27. Salvetti G, Santini F, Versari D, et al. Fat distribution and cardiovascular risk in obese women. Obes Metab Milan 2008; 4: 202–7.

    Google Scholar 

  28. Yusuf S, Hawken S, Ounpuu S, et al., INTERHEART Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 2005; 366: 1640–9.

    Article  PubMed  Google Scholar 

  29. Rutter MK, Parise H, Benjamin EJ, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation 2003; 107: 448–54.

    Article  PubMed  CAS  Google Scholar 

  30. Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function: the Strong Heart Study. Circulation 2000; 101: 2271–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the following grants: “Pathogenetic mechanisms determining the obese phenotype and influencing the response to treatment” Ministero dell’Università e della Ricerca, Programmi di Ricerca Scientifica 2007; “Integrate protocols for the prevention and the treatment of obesity” Ministero della Salute, Programmi di Ricerca Finalizzata 2006; “Obesità: identificazione e sperimentazione di nuove strategie per la prevenzione dell’obesità e delle sue complicanze” Ministero del Lavoro, della Salute e delle Politiche Sociali, CCM 2008.

All the authors declare no conflicts of interest related to this study.

Author information

Authors and Affiliations

  1. Obesity Centre at the Endocrinology Unit, University of Pisa, Via Paradisa, 2, 56124, Pisa, Italy

    Guido Salvetti, Andrea Pucci, Paola Fierabracci, Giovanni Ceccarini, Paolo Vitti, Aldo Pinchera & Ferruccio Santini

  2. Cardiac and Thoracic Department, University of Pisa, Pisa, Italy

    Caterina Palagi, Maria Grazia Delle Donne & Vitantonio Di Bello

  3. Department of Energy and Systems Engineering, University of Pisa, Pisa, Italy

    Paolo Piaggi

  4. Department of Internal Medicine, University of Pisa, Pisa, Italy

    Antonio Salvetti

Authors
  1. Guido Salvetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Pucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paola Fierabracci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giovanni Ceccarini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Caterina Palagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Grazia Delle Donne
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vitantonio Di Bello
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paolo Piaggi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Paolo Vitti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Antonio Salvetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Aldo Pinchera
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Ferruccio Santini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guido Salvetti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Salvetti, G., Pucci, A., Fierabracci, P. et al. Prevalence of Left Ventricular Hypertrophy and Determinants of Left Ventricular Mass in Obese Women. High Blood Press Cardiovasc Prev 19, 33–39 (2012). https://doi.org/10.2165/11593700-000000000-00000

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11593700-000000000-00000

key words

Search

Navigation