RELATIONSHIP BETWEEN OBESITY AND LEFT VENTRICULAR MASS IN CAUCASIAN HYPERTENSIVE SUBJECTS. DOES SEX MATTER?

ObjectiveThe excess of adiposity affects the heart through haemodynamic and non haemodynamic mechanismsleading to left ventricular hypertrophy (LVH) and ultimately to heart failure. It has been been previously observed, in alarge study performed in American Indians, that the impact of obesity on left ventricular mass (LVM) is greater in womenthan men, while the results of other investigations carried out in other ethnic groups have yielded conflicting results .Theaim of our study was to evaluate the potential influence of gender on the relationships between obesity and LVM inCaucasian patients with essential hypertension (EHs) .Design and methodWe enrolled 724 subjects with EH (mean age 45 ± 12 years, 63 % men ) without cardiovascular complications.In all subjects the anthropometric indices (weight, height and waist circumference ) and the routinebiochemical parameters were determined . Furthermore, all patients underwent a 24-h blood pressure monitoring and anechocardiogram. LVM was indexed for body surface area (LVMI ) and for height2.7 (LVMH2.7) .ResultsThe univariate correlations of LVM , LVMI , LVMH2.7 with body mass index (BMI) and the comparison of Pearsoncoefficients between the two sexes, evaluated using the Fisher r-to-z transformation, are shown in the following table.The greatest strength of the association of obesity with LVM , LVMI , LVMH2.7 in women than in men wasalso confirmed (p always < 0.01) in multivariate models, where the interaction term “sex x obesity' was added along withmultiple confounding factors. Similar results were obtained when as an index of adiposity waist circumference was usedinstead of BMI.ConclusionsOur study seems to indicate that in Caucasians hypertensive subjects the impact of obesity and overweight on LVM isgreater in women than in men.