Obesity Complications Compound Risk for Left Ventricular Hypertrophy
By Will Boggs M.D.
NEW YORK (Reuters Health) Jan 18 - Several complications of severe obesity contribute to the development of left ventricular hypertrophy, according to a report in the January issue of Hypertension.
"Obesity compounds the well known adverse effects of hypertension on the heart," Dr. Sheldon E. Litwin told Reuters Health. "Sleep apnea and obesity also have multiplicative effects on increasing LV mass. Because of these interactions, the triad of these three conditions (obesity, hypertension, and sleep apnea) may be particularly stressful to the heart."
Dr. Litwin at the University of Utah School of Medicine in Salt Lake City, and colleagues investigated whether such coexisting conditions as obstructive sleep apnea and hypertension would contribute to the extent and pattern of left ventricular remodeling in patients with severe obesity who met criteria for gastric bypass surgery.
Two thirds of obese patients had abnormal left ventricular geometry, the researchers report, with left ventricular concentric hypertrophy representing the most common pattern. Myocardial function was significantly decreased in the obese patients. |
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More than 80% of the obese patients who underwent a sleep study met criteria for obstructive sleep apnea, the results indicate. Obese patients with obstructive sleep apnea were more likely than those without apnea to have hypertension and a higher heart rate.
In a multivariate regression model, systolic blood pressure, body-mass index, and average nocturnal oxygen saturation were independently associated with left ventricular mass.
There were synergistic effects of the combination of body-mass index and hypertension and the combination of hypertension and average nocturnal oxygen saturation on left ventricular mass index, the researchers report.
"We are conducting an ongoing, NIH-funded trial examining the cardiovascular effects of severe obesity, and whether these effects can be altered/attenuated by weight loss achieved via bariatric surgery," Dr. Litwin said.
Hypertension 2007;49:34-39. |
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