Abstract 2402: Differential Impact of Left Ventricular Mass and Relative Wall Thickness on Cardiovascular Prognosis in Diabetic and Non-diabetic hypertensive subjects
Introduction: Effect of left ventricular (LV) hypertrophy on cardiovascular prognosis in type2 diabetes has not yet been described.
Hypothesis: Prognostic significance of LV structural change (LV mass index: LVMI and relative wall thickness: RWT) would be different in diabetic hypertensives compared with non-diabetic hypertensives.
Methods: Ambulatory BP monitoring and echocardiography were performed in 400 Japanese uncomplicated hypertensives at baseline and 379 patients (94.8%) were successfully followed up for 49 ± 19 months (mean age: 67.8 ± 8.8 years, 157 diabetes and 222 non-diabetes, 139 men and 240 women). LVMI and RWT were dichotomized to the highest quartile vs. other 3 quartiles for further categorical analyses.
Results: Thirty one cardiovascular events occurred during the follow up period. With Kaplan-Meier analysis, the highest quartile of LVMI had significantly higher incidence of cardiovascular events both in the diabetics and non-diabetics. However, the highest quartile of RWT was associated with cardiovascular events only in the diabetics (Figure⇓). With Cox regression analyses controlling for age, sex, body mass index, diabetes, smoking, antihypertensive drugs, cholesterol, 24-hr systolic BP, and serum creatinine, RWT [×100; relative risk (RR): 1.07, 95%CI;1.01–1.14, P=0.027] but not LVMI (g/m2) was associated with cardiovascular events in the diabetics, whereas LVMI (RR: 1.02, 95%CI;1.00 –1.04, P=0.025) but not RWT was associated with cardiovascular events in non-diabetics.
Conclusions: LV relative wall thickness may be more important than LVMI in predicting cardiovascular events in hypertensive patients with type 2 diabetes.