ELECTROCARDIOGRAPHIC LEFT VENTRICULAR REGRESSION INDUCED BY AN ANGIOTENSIN RECEPTOR BLOCKER-BASED REGIMEN IN HYPERTENSIVE PATIENTS ACCORDING TO BODY MASS INDEX: PP.35.456

Abstract

Aims: This study examined the influence of body mass index (BMI) on left ventricular hypertrophy (LVH) detected by different electrocardiographic (ECG) criteria and the potential changes induced by an antihypertensive therapy from the SARA study database. Patients and Methods: The SARA study was aimed to determine the effect of a 12-month candesartan-based regimen on ECG-LVH. Overall, 264 patients were included. Patients were divided into 2 groups according to BMI. Obesity was defined as a BMI>27 Kg/m2. The analyzed ECG-LVH criteria were: Cornell voltage index (CorV), Cornell product (CorP), Sokolow-Lyon voltage index (SokV), and Sokolow-Lyon product (SokP). Results: At baseline, 53.8% (n = 142) had a BMI >27 Kg/m2 (Ob) vs 46.2% with BMI <27 kg/m2 (No-Ob). The main clinical characteristics of both groups (No-Ob vs Ob): age 62.23 ± 12.74 vs 63.41 ± 10.53 years, p = NS; gender [women] 42.7% vs 54.4%, p < 0.01; BMI 24.83 ± 1.59 vs 30.46 ± 3.45 Kg/m2, p < 0.001; diabetes 10.3% vs 20.6%, p < 0.001; systolic blood pressure 160.42 ± 12.96 vs 161.35 ± 15.72 mmHg, p = NS, and diastolic blood pressure 93.67 ± 8.83 vs 94.40 ± 10.26 mmHg, p = NS. At baseline, no differences were found in the prevalence of ECG-LVH, between groups regardless the ECG criteria analyzed. However, at study end, the reduction of CorV criterion with the candesartan-based therapy was significantly higher in obese patients (-0.30 vs -1.49 mm, p = 0.021); and there was a trend with CorP (-6.66 vs -152.93 mm x mV, P = 0.078), without significant differences between groups when SokV and SokP were analyzed. These data were more evident in male (No-Ob vs Ob): CorV +0.54 vs – 0.95 mm, p = 0.021; CorP +125.98 vs -120.35 mm x mV, p = 0.048; SokP -66.56 vs -257.86 mm x mV, p = 0.044; and SokV +0.21 vs -1.65 mm, p = 0.076. Conclusions: Although the prevalence of ECG-LVH was similar at baseline regardless BMI values, obese patients achieved higher reductions in ECG-LVH than non obese hypertensive patients with a candesartan-based regimen after a 12-month follow-up.