Left ventricular hypertrophy in hypertensive type 2 diabetic patients according to renal function

Aim. - Cardiovascular disease is the main cause of death in diabetic patients undergoing haemodialysis. Dialysis and hypertension increase left ventricular hypertrophy (LVH), a strong predictor of cardiovascular events. This study evaluated left ventricular structure and function in three groups of hypertensive type 2 diabetic patients with different renal function, and assessed the factors associated with LVH, in an Afro-Caribbean population. Methods. - Left ventricular structure and function were measured by ultrasonography. Group I consisted of 150 patients with normal renal function, group 2 included 183 patients with renal dysfunction and the third group comprised 75 dialysis patients. Results. - Left ventricular mass/height(2.7) increased from group I to groups 2 and 3 (49.00 g/m(2.7), 57.12 g/m(2.7) and 59.75 g/m(2.7), respectively; P < 0.0001). The prevalences of LVH were 48.3% in group 1, 64.8% in group 2 and 70.3% in the dialysis patients (P = 0.001). LVH was more concentric than eccentric in groups 2 and 3. The factors significantly associated with LVH were obesity in groups 1 and 2, and an increase of 10 mmHg in pulse pressure in groups 2 and 3, according to multivariate logistic-regression analysis. Conclusion. - Our study confirmed that, in a population of Afro-Caribbean hypertensive type 2 diabetic patients, renal failure was associated to an increased left ventricular mass/height(2.7). The data show that the variables associated with LVH differ according to renal profile. This finding will be of value in the treatment and follow-up of these patients. (C) 2009 Elsevier Masson SAS. All rights reserved.