Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

Journal of Human Hypertension volume 17, pages 305–311 (2003)Cite this article

Abstract

Vascular hypertrophy and insulin resistance have been associated with abnormal left ventricular (LV) geometry in population studies. We wanted to investigate the influence of vascular hypertrophy and insulin resistance on LV hypertrophy and its function in patients with hypertension. In 89 patients with essential hypertension and electrocardiographic LV hypertrophy, we measured blood pressure; insulin sensitivity by hyperinsulinaemic euglucaemic clamp; minimal forearm vascular resistance (MFVR) by plethysmography; intima-media cross-sectional area of the common carotid arteries (IMA) by ultrasound; and LV mass, relative wall thickness (RWT), systolic function and diastolic filling by echocardiography after two weeks of placebo treatment. LV mass index correlated to IMA/height (r=0.36, P=0.001), serum insulin (r=−0.25, P<0.05), plasma glucose (r=−0.34, P<0.01), and showed a tendency towards a correlation to insulin sensitivity (r=0.21, P=0.051), but was unrelated to MFVR. Deceleration time of early diastolic transmitral flow positively correlated to IMA/height (r=0.30, P<0.01). The ratio between early and atrial LV filling peak flow velocity negatively correlated to MFVRmen (r=−0.30, P<0.05). Endocardial and midwall systolic LV function were not related to vascular hypertrophy, plasma glucose, serum insulin or insulin sensitivity. In conclusion, insulin resistance was not related to LV hypertrophy or reduced LV function. However, high thickness of the common carotid arteries was associated with LV hypertrophy and high deceleration time of early diastolic transmitral flow. High MFVR was associated with low ratio between early and atrial LV filling peak flow velocity. This may suggest that systemic vascular hypertrophy contributes to abnormal diastolic LV relaxation in patients with hypertension and electrocardiographic LV hypertrophy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Jones EC et al. Relation of hemodynamic volume load to arterial and cardiac size. J Am Coll Cardiol 1997; 29: 1303–1310.

    Article  CAS  Google Scholar 

  2. Olsen MH et al. Is cardiovascular remodeling in patients with essential hypertension related to more than high blood pressure? A LIFE substudy. Am Heart J 2002; 144: 530–537.

    Article  Google Scholar 

  3. Phillips RA et al. Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects. J Clin Endocrinol Metab 1998; 83: 4284–4288.

    CAS  PubMed  Google Scholar 

  4. O'Rourke MF, Yaginuma T, Avolio AP . Physiological and pathophysiological implications of ventricular/vascular coupling. Ann Biomed Eng 1984; 12: 119–134.

    Article  CAS  Google Scholar 

  5. Ting CT et al. Arterial hemodynamics in human hypertension. J Clin Invest 1986; 78: 1462–1471.

    Article  CAS  Google Scholar 

  6. Howard G et al. Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 1996; 93: 1809–1817.

    Article  CAS  Google Scholar 

  7. Olsen MH et al. Relative influence of insulin resistance versus blood pressure on vascular changes in longstanding hypertension. ICARUS, a LIFE substudy. J Hypertens 2000; 18: 75–81.

    Article  CAS  Google Scholar 

  8. Dahlof B et al. Characteristics of 9194 patients with left ventricular hypertrophy: the LIFE study. Hypertension 1998; 32: 989–997.

    Article  CAS  Google Scholar 

  9. Howard G et al. Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC investigators. Stroke 1993; 24: 1297–1304.

    Article  CAS  Google Scholar 

  10. DeFronzo RA, Simonson D, Ferrannini E . Hepatic and peripheral insulin resistance: a common feature of type 2 (non-insulin-dependent) and type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1982; 23: 313–319.

    Article  CAS  Google Scholar 

  11. Polonsky KS, Given BD, van Cauter E . Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects. J Clin Invest 1988; 81: 442–448.

    Article  CAS  Google Scholar 

  12. Lillioja S, Bogardus C . Obesity and insulin resistance: lessons learned from the Pima Indians. Diabetes Metab Rev 1988; 4: 517–540.

    Article  CAS  Google Scholar 

  13. Ader M, Bergman RN . Insulin sensitivity in the intact organism. Baillieres Clin Endocrinol Metab 1987; 1: 879–910.

    Article  CAS  Google Scholar 

  14. Best JD, Taborsky-GJ J, Halter JB, Porte D . Glucose disposal is not proportional to plasma glucose level in man. Diabetes 1981; 30: 847–850.

    Article  CAS  Google Scholar 

  15. Folkow B . Physiological aspects of primary hypertension. Physiol Rev 1982; 62: 347–504.

    Article  CAS  Google Scholar 

  16. Cooper KE, Edholm OG, Mottram RF . The blood flow in skin and muscle of the human forearm. J Physiol 1954; 128: 258–267.

    Article  Google Scholar 

  17. Palmieri V et al. Reliability of echocardiographic assessment of left ventricular structure and function: the PRESERVE study. Prospective Randomized Study Evaluating Regression of Ventricular Enlargement. J Am Coll Cardiol 1999; 34: 1625–1632.

    Article  CAS  Google Scholar 

  18. de Simone G et al. Assessment of left ventricular function by the midwall fractional shortening/end-systolic stress relation in human hypertension. J Am Coll Cardiol 1994; 23: 1444–1451.

    Article  CAS  Google Scholar 

  19. Gaasch WH et al. Stress-shortening relation and myocardial blood flow in compensated and failing canine hearts with pressure-overload hypertrophy. Circulation 1989; 79: 872–883.

    Article  CAS  Google Scholar 

  20. Dubin J, Wallerson DC, Cody RJ, Devereux RB . Comparative accuracy of Doppler echocardiographic methods for clinical stroke volume determination. Am Heart J 1990; 120: 116–123.

    Article  CAS  Google Scholar 

  21. Nishimura RA, Abel MD, Hatle LK, Tajik AJ . Assessment of diastolic function of the heart: background and current applications of Doppler echocardiography. Part II. Clinical studies. Mayo Clin Proc 1989; 64: 181–204.

    Article  CAS  Google Scholar 

  22. Appleton CP, Hatle LK, Popp RL . Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 1988; 12: 426–440.

    Article  CAS  Google Scholar 

  23. Klein AL et al. Effects of age on left ventricular dimensions and filling dynamics in 117 normal persons. Mayo Clin Proc 1994; 69: 212–224.

    Article  CAS  Google Scholar 

  24. Andersen L et al. Enzyme immunoassay for intact human insulin in serum or plasma. Clin Chem 1993; 39: 578–582.

    CAS  PubMed  Google Scholar 

  25. Roman MJ et al. Parallel cardiac and vascular adaptation in hypertension. Circulation 1992; 86: 1909–1918.

    Article  CAS  Google Scholar 

  26. Saba PS et al. Relation of arterial pressure waveform to left ventricular and carotid anatomy in normotensive subjects. J Am Coll Cardiol 1993; 22: 1873–1880.

    Article  CAS  Google Scholar 

  27. Bergbrant A, Hansson L, Jern S . Interrelation of cardiac and vascular structure in young men with borderline hypertension. Eur Heart J 1993; 14: 1304–1314.

    Article  CAS  Google Scholar 

  28. Agabiti-Rosei E et al. Relation between cardiac hypertrophy and forearm vascular structural changes before and during long-term antihypertensive treatment. Am J Med 1988; 84: 125–128.

    Article  CAS  Google Scholar 

  29. Olsen MH et al. The importance of changes in conduit and peripheral arteries for coronary flow reserve in patients with hypertension. A LIFE substudy. J Am Coll Cardiol 1999; 33: 279A.

    Google Scholar 

Download references

Acknowledgements

We acknowledge the technical assistance by Lisa Krause in Ann Arbor, Merete Molvig in Oslo and Ingrid Emanuel in Copenhagen.

Author information

Authors and Affiliations

  1. Department of Clinical Physiology and Nuclear Medicine, Glostrup University Hospital, Copenhagen, Denmark

    M H Olsen

  2. Department of Internal Medicine, Glostrup University Hospital, Copenhagen, Denmark

    M H Olsen, K Wachtell & H Ibsen

  3. Department of Cardiology and Nephrology, Ullevaal University Hospital, Oslo, Norway

    E Hjerkinn, A Høieggen, E Fossum & S E Kjeldsen

  4. Department of Cardiology, Weill Medical College of Cornell University, NY, USA

    J N Bella

  5. Hypertension Division, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA

    S D Nesbitt & S Julius

Authors
  1. M H Olsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E Hjerkinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K Wachtell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Høieggen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J N Bella
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S D Nesbitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E Fossum
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S E Kjeldsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. S Julius
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. H Ibsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M H Olsen.

Additional information

Supported in part by grant from Merck & Co., Inc., West Point, PA, USAPotential conflicts of interest: None

Rights and permissions

Reprints and permissions

About this article

Cite this article

Olsen, M., Hjerkinn, E., Wachtell, K. et al. Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy. J Hum Hypertens 17, 305–311 (2003). https://doi.org/10.1038/sj.jhh.1001545

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001545

Keywords

This article is cited by

Search

Advanced search

Quick links