ABDOMINAL OBESITY IS ASSOCIATED WITH DIASTOLIC DYSFUNCTION IN YOUNG PRE- AND HYPERTENSIVE SUBJECTS INDEPENDENTLY OF BLOOD PRESSURE LEVELS AND INSULIN RESISTANCE

Objective: Metabolic syndrome is one of the most important conditions affecting diastolic function. We aimed to investigate early associations of abdominal obesity and lipid and carbohydrates metabolism with preclinical decline of diastolic function in treatment-naive young patients with hypertension. The aim of our study was to investigate the association of abdominal obesity and insulin resistance with diastolic function in young patients with first time diagnosed hypertension. Design and method: We evaluated anthropometric and metabolic characteristics, clinical blood pressure (BP) and 24-hours ambulatory blood pressure monitoring and performed echocardiography in 106 young (18-45 years old) never treated hypertensives (age 22 [21; 25] years, 85% males, body mass index (BMI) 25,8±4,9 kg/m2) free of diabetes mellitus. We divided all patients into subgroups according to median e’ and E/e’. Then we compared main clinical variables including obesity characteristics, common markers of lipid and carbohydrates metabolism and blood pressure levels in derived subgroups. We used Student's t-test and Mann-Whitney U-test to compare variables with normal and non-normal distribution, respectively. Results: There was no difference in age, lipids, HbA1c, HOMA-IR, clinical and ambulatory BP levels between subgroups divided according to median e’ and E/e’. We observed significant differences in body mass index, waist circumference and waist-to-height ratio. Then we compared main variables of diastolic function in patients with or without abdominal obesity (AO). Patients with AO had lower e’ and higher E/e’ than patients without AO: 10,5 vs 12,0 (<0,0001) and 7,7 vs 6,5 (<0,0001), respectively. There was no difference in tricuspid regurgitation velocity and left atrial volume index as in BP levels. We performed multiple regression analysis with e’ as dependent variable and age, sex, low density lipoproteins, glucose, HOMA-IR, office systolic and diastolic blood pressure and AO as independent variables. AO along with age remained independently associated with e’ (β= -1,716, p = 0,002 and β= -0,173, p < 0,001, respectively). Conclusions: In young hypertensive treatment-naive patients myocardial relaxation and left ventricular filling pressure estimated with e’ and E/e’ significantly differ between patients with or without AO irrespective of the presence of arterial hypertension and insulin resistance.