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Determinants of myocardial hypertrophy in mild essential hypertension impact of dietary salt intake on left ventricular hypertrophy



Determinants of myocardial hypertrophy in mild essential hypertension impact of dietary salt intake on left ventricular hypertrophy



Zeitschrift fuer Kardiologie 79(8): 557-564



The impact of clinical parameters on the pathogenesis of myocardial hypertrophy was examined in 75 male patients with mild essential hypertension. Clinical parameters were age, body weight, sodium excretion (as an estimate for dietary salt intake), systolic and diastolic blood pressure at work, casual blood pressure, resting and stress blood pressure during mental stress test and physical exercise. Left ventricular mass as a parameter for the degree of left ventricular hypertrophy was assessed by 2-D guided M-mode echocadiography. Left ventricular mass correlated with body weight (r = 0.47, p < 0.002), with body mass index (r = 0.48, p < 0.01), with systolic blood pressure at the worksite (r = 0.28, p .ltoreq. 0.05), and systolic blood pressure at rest (r = 0.35, P .ltoreq. 0.01), whereas no correlation was found between casual or stress blood pressure readings during physical exercise and mental stress with the degree of left ventricular hypertrophy. Sodium excretion was related to the end-diastolic diameter of the left ventricle (r = 0.33, p .ltoreq. 0.01) and to left ventricular mass (r = 0.35, p .ltoreq. 0.01). Multiple regression analysis revealed that sodium excretion over 24 hours, systolic blood pressure at the worksite and body mass index were independent determinants of left ventricular mass. Thus, dietary salt intake was found to modulate the degree of ventricular hypertrophy independently of the pressure load imposed on the myocardium. These data indicate that the development of left ventricular hypertrophy can be accelerated by excessive dietary salt intake and conversely, salt restriction may mitigate this development in patients with essential hypertension.

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