Abstract 19856: No Impact of Weight Gain on Blood Pressure and Left Ventricular Mass Variation in Hypertensive Patients with Left Ventricular Hypertrophy: the LIFE Study.
Background: Although decrease in body weight (BW) substantially influences blood pressure (BP) reduction, it is unclear whether changes in BW affect BP control and cardiovascular (CV) phenotype in hypertensive subjects with LV hypertrophy (LVH) during systematic treatment to pre-specified BP targets. Thus, we evaluated the relations between changes in BW (ΔBW) and changes in BP and CV phenotype (evaluated as percent changes from baseline values), over 4.8 years of follow-up in participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, according to intention-to-treat analysis.
Methods: We analyzed data from 8599 treated hypertensive patients with ECG LVH (by Cornell voltage duration product or Sokolow-Lyon voltage) and available follow-up BW measurements (53% women; mean age 67±7 yrs), 788 of whom also underwent echocardiographic exam. The population was divided into tertiles of ΔBW. The highest tertile of increase in BW was compared to the others, by ANCOVA adjusting for age, gender, diabetes (DM), randomized treatment and prevalent CV disease.
Results: The 2847 participants (33%) exhibiting BW gain during follow-up, had slightly lower baseline BW than those maintaining or reducing BW (77±15 vs. 78±15 Kg, p<0.0001), with no significant differences for age, sex, randomized treatment or prevalent DM, obesity or CV disease. Percent decrease in BP (systolic, diastolic and pulse) were nearly identical in the two groups. Similarly, reductions of both Cornell and Sokolow-Lyon were similar, without differences in the prevalence of LVH at the end of the follow-up. In the echo-substudy, no significant differences were found in reduction in arterial stiffness (estimated as pulse pressure/stroke index ratio: −19% in participants who gained BW vs −16% in those who maintained or reduced BW) and LV mass index (−15% vs. −17%). However, increase in stroke index was significantly higher in participants who gained BW (6.2 vs 3.3%, p=0.04).
Conclusions: In aggressively-treated hypertensive patients with LVH, in-treatment BW gain is not related to modifications of BP, LV mass or arterial stiffness, whereas it is associated with increase in volume load.
- © 2010 by American Heart Association, Inc.