High BP With Enlarged Heart Raises Diabetes Risk

People who suffer from high blood pressure who are also found to have an abnormal enlargement of the heart’s main pumping chamber — the left ventricle — are at an increased risk of developing diabetes, results of a study indicate. Dr. Peter M. Okin lead investigator states that, “Patients with high blood pressure and an enlarged left ventricle, known as left ventricular hypertrophy or LVH, whose LVH does not regress with blood pressure lowering are at increased risk of developing diabetes.”

LVH can arise from uncontrolled high blood pressure, and the condition is known to increase the risk of heart attack, heart failure and stroke.

Okin advises doctors to follow how patients with high blood pressure respond to blood pressure lowering medication and "consider following the response of LVH to treatment, to better assess risk in their patients with hypertension."

In their study, Okin from Cornell University Medical Center, New York and colleagues found that patients whose LVH resolved during blood pressure lowering therapy had a 38 percent lower incidence of new diabetes than did patients with persistent LVH.

"In addition to following blood pressure response to antihypertensive therapy," he advised, "physicians should consider following the response of ECG LVH to treatment, to better assess risk in their patients with hypertension."

"The simple, widely available, and inexpensive routine ECG is a powerful noninvasive marker of risk when used in serial assessment of patients," Dr. Okin said. "In the LIFE Study, we assessed ECG LVH at 6 months and then annually thereafter. This would seem like a reasonable approach until additional studies are done to examine optimal timing of assessment."
Dr. Giuseppe Schillaci and colleagues from the University of Perugia, Italy in a related editorial stated that, The study "extends our knowledge and understanding of the importance of LVH reversal by showing the beneficial metabolic effects of treatment-induced regression of LVH in a large series of patients with hypertensive heart disease."

The increased risk of diabetes in patients with LVH during therapy persisted after adjusting for a number of factors, the investigators say.
Hypertension, November 2007.

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