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[PP.18.06] EARLY ADVERSE EFFECT OF ABNORMAL GLUCOSE METABOLISM ON LEFT VENTRICULAR MASS IN NEVER TREATED HYPERTENSIVE PATIENTS

Objective: Left ventricular hypertrophy is independently associated with increased cardiovascular risk in hypertensive patients. Abnormal glucose metabolism has been shown to augment target organ damage, but whether there is a grading adverse effect of the progressively increased stages of dysglycemia on left ventricular mass, is not well clarified. Design and method: We investigated 630 never treated hypertensive patients (mean age = 54 years). We stratified patients according to the glucose metabolic status into 3 groups: 1. patients with normal fasting glucose (NFG, N = 312), 2. patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) (N = 236), and 3. patients with diabetes mellitus II (DM II, N = 82). An echocardiogram was performed in all participants and left ventricular mass index (LVMI) was calculated according to the Devereux's formula. Results: There was a gradual increase in LVMI from patients with NFG to patients with IFG/IGT and DM II (from 119.9 to 127.7 to 129.5 g/m2, p < 0.001). Post-hoc analysis showed that the difference in LVMI was significant between the groups of NFG and IFG/IGT (p < 0.001) and between NFG and DM II (p < 0.001) but no statistically significant difference was demonstrated between patients with IFG/IGT and DM II (p = NS). LVMI was independently associated with glucose metabolic group after adjustment for age, gender, smoking and mean arterial pressure (p = 0.001). Conclusions: Early abnormal glucose abnormalities, such as IFG and IGT, are associated with increased LVMI in hypertensive patients. Moreover, the adverse effect of IFG/IGT on LVMI is comparable to that of DM II, implying that premature, significant alterations in LVM are already shown from the prediabetic stage, without further enhancement at the diabetic status. Thus, in hypertensive patients, lifestyle and/or pharmaceutical modifications focusing on the reduction of blood glucose to the normal levels should be strongly encouraged.