P-379: Genetic predisposition to hypertension influences left ventricular changes during antihypertensive therapy

Genetic factors play a relevant role in linking insulin resistance and essential hypertension, also influencing insulin sensitivity during antihypertensive therapy.Insulin resistance can affect left ventricular (LV) diastolic function through hyperinsulinemia that stimulates collagen production.Using digitized M-mode echocardiograms, 24 hour blood pressure (BP) monitoring and oral glucose tolerance test, we evaluated the influence of genetic predisposition to hypertension on LV changes during antihypertensive treatment. We enrolled 36 never-treated hypertensives (H) (24h BP > 135 and/or 85 mmHg)(20 men, 47±10 years; BMI 25.3±3.4 Kg/m2) with normal glucose tolerance: 18 with both parents hypertensive (F+), 18 with normotensive parents (F−). Before and after 18 months of ACE inhibitor treatment we measured: 24h, day,night systolic and diastolic BP, metabolic clearance rate of glucose (MCR), LV mass index, peak shortening and peak lengthening rate (+dD/dt) of LV diameter, peak thinning rate of LV posterior wall (dW/dt). Basal evaluation: HF+ and HF- differed only in insulin sensitivity (MCR 8.1±1.5 vs 9.5±1.3 mg · Kg−1 · min−1, p=0.005) and in LV diastolic function (+dD/dt 4.1±1 vs 5.1±1.3 s−1, p=0.014; dW/dt 10.5±2.8 vs 12.6±2.4 cm/s,p=0.021), both lower in HF+. After treatment: 24h BP and LV mass index decreased (p