Roberto de Cleva1,2, Victor Arrais Araujo3, Carla Cristina Ornelas Buchalla3, Fabio de Oliveira Costa3, Acácio Fernandes Cardoso3, Denis Pajecki3, Marco Aurelio Santo3. 1. Hospital das Clínicas, Gastroenterology Department, University of São Paulo Medical School, AV. Dr. Arnaldo, 455, Cerqueira César, São Paulo, SP, CEP: 01246-000, Brazil. roberto.cleva@uol.com.br. 2. , Rua Cel Artur Godoi 125, apto 152, Vila Mariana, São Paulo, SP, CEP: 04018-050, Brazil. roberto.cleva@uol.com.br. 3. Hospital das Clínicas, Gastroenterology Department, University of São Paulo Medical School, AV. Dr. Arnaldo, 455, Cerqueira César, São Paulo, SP, CEP: 01246-000, Brazil.
Abstract
PURPOSE: The purpose of this study is to correlate the left ventricular hypertrophy (LVH) patterns according to severe obesity and arterial hypertension (AHT) grades. METHODS: A cross-sectional prospective study was conducted in 379 patients with severe obesity. Obesity was classified according to the BMI in the following: morbidly obese (MO; 40 < BMI < 50 kg/m2) and super obese (SO; BMI > 50 kg/m2). The AHT was classified into classes 1 and 2 according to American Heart Association. The presence of LVH and the pattern of cardiac remodeling were determined by transthoracic echocardiography. RESULTS: LVH was present in 58.6% of patients. Obesity and AHT had additive effects in LVH prevalence. LVH was found in 32.9 and 46.7% of MO with AHT grades 1 and 2, respectively. LVH was diagnosed in 39.1% in SO with AHT grade 1 and in 50% of AHT grade 2. Patients with AHT presented a significantly higher risk of developing LVH (OR 1.97; p = 0.003). Hypertension grade was also a determinant variable in the development of LVH. Patients with AHT 2 had 4.31-fold greater risk (p < 0.001) when compared to normotensive patients. BMI was only considered an independent risk factor for LVH in patients with BMI greater than 47.17 kg/m2 (OR 1.62; p = 0.023). CONCLUSION: AHT is a stronger predictive factor of LVH than obesity grade.
PURPOSE: The purpose of this study is to correlate the left ventricular hypertrophy (LVH) patterns according to severe obesity and arterial hypertension (AHT) grades. METHODS: A cross-sectional prospective study was conducted in 379 patients with severe obesity. Obesity was classified according to the BMI in the following: morbidly obese (MO; 40 < BMI < 50 kg/m2) and super obese (SO; BMI > 50 kg/m2). The AHT was classified into classes 1 and 2 according to American Heart Association. The presence of LVH and the pattern of cardiac remodeling were determined by transthoracic echocardiography. RESULTS: LVH was present in 58.6% of patients. Obesity and AHT had additive effects in LVH prevalence. LVH was found in 32.9 and 46.7% of MO with AHT grades 1 and 2, respectively. LVH was diagnosed in 39.1% in SO with AHT grade 1 and in 50% of AHT grade 2. Patients with AHT presented a significantly higher risk of developing LVH (OR 1.97; p = 0.003). Hypertension grade was also a determinant variable in the development of LVH. Patients with AHT 2 had 4.31-fold greater risk (p < 0.001) when compared to normotensive patients. BMI was only considered an independent risk factor for LVH in patients with BMI greater than 47.17 kg/m2 (OR 1.62; p = 0.023). CONCLUSION: AHT is a stronger predictive factor of LVH than obesity grade.
Entities:
Keywords:
Hypertension; Left ventricular hypertrophy; Severe obesity
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