Relation of blood pressure and body build to left ventricular mass in normotensive and hypertensive employed adults

Left ventricular muscle mass is increased in the presence of large body size, high blood pressure and obesity, but the relative contributions to ventricular mass of these and other factors have not been elucidated. Accordingly, echocardiographic left ventricular mass in unmedicated employed adults (162 normotensive, 145 borderline hypertension and 317 with established essential hypertension) was related to height, weight, lean body mass, body mass index, systolic and diastolic blood pressure, age, gender, race and 24 h urinary sodium and potassium excretion. In the total population, body mass index, systolic blood pressure and height were the most significant (p < 0.0001) independent correlates of left ventricular mass, whereas gender and age made smaller contributions. In each normotensive and hypertensive subgroup, body mass index and height remained highly significant independent predictors of left ventricular mass, systolic blood pressure became a weaker predictor (0.001 < p < 0.02) and only among patients with established hypertension was diastolic blood pressure a weak independent determinant (p < 0.05) of ventricular mass. The increase in left ventricular mass attributable to obesity was due to eccentric hypertrophy because end-diastolic relative wall thickness was similar in obese and nonobese subjects in each blood pressure group. Thus obesity, as measured by body mass index, is as important a potential determinant of left ventricular muscle mass as is systolic blood pressure and it is of greater statistical significance in an adult employed population than is diastolic blood pressure, height, gender, age or dietary sodium intake.