DOI: http://dx.doi.org/10.18203/2349-3933.ijam20204059

Correlation between echocardiographic left ventricular mass and atherogenic index of plasma in adult hypertensive subjects in Olabisi Onabanjo university teaching hospital, Sagamu

Olajide O. Oresegun, Okechuku S. Ogah, Oluranti B. Familoni, Akintunde Akinpelu

Abstract


Background: Hypertension and dyslipidaemia are two major modifiable cardiovascular risk factors with their co-existence having more than an additive effect on endothelial function causing atherosclerosis. The purpose of this study was to determine the prevalence of dyslipidaemia in hypertensive subjects and to determine its relationship left ventricular hypertrophy.

Methods: The study was a cross-sectional comparative one involving 120 hypertensive participants with LVH (subjects) and 60 age and sex-matched hypertensive participants without LVH (controls). Detailed history, physical examination, fasting lipid profile test, and echocardiogram were carried out on all participants.

Results: The overall prevalence rate of dyslipidaemia in the study was 61.1%. The prevalence of dyslipidaemia in subjects (60.8%) was slightly lower than in controls (61.7%), though the difference was not statistically significant (p=0.914). The most common isolated lipid abnormality in the study was elevated serum LDL-C (55% in subjects, 46.7% in controls), though the difference did not achieve statistical significance (p= 0.370). The mean atherogenic index of plasma (AIP) was significantly higher in the subjects (0.34+0.23) than in the controls (0.22+0.28) (p=0.001). There was a positive correlation between echocardiographic left ventricular mass and AIP (r=0.298, p=0.001).

Conclusion: There is a high prevalence of dyslipidaemia among hypertensive adults. There is also a positive correlation between echocardiographic left ventricular mass and AIP among adult hypertensive subjects.


Keywords


Hypertension, Echocardiogram, Left ventricular mass, Dyslipidaemia, AIP, Atherosclerosis

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References


World Health Organization. NCD Mortality and Morbidity, Global Health Observatory. 2018. Available from http:/www.who.int/gho/ncd/mortalitymorbidity/en/index.html>http://www.who.int/gho/ncd/mortality-morbidity/en/index.html. Accessed on 15/07/2020.

Jamshed J, Padmanabhan T, Piyush J, Shiva P, Hardik V, Ashish G. Lipitension: Interplay between dyslipidemia and hypertension. Indian J Endocrinol Metab. 2012;16:240-5.

Liao D, Mo J, Duan Y, Lin HM, Darnell M, Quan Z. The joint effect of hypertension and elevated LDL- Cholesterol on coronary heart disease is beyond additive. Eur Heart J. 2004;25:235.

World Health Organization. Global Health Observatory. Non communicable diseases country profile. Nigeria 2018. Available from htpp://www.who.int/nmh/countries/nga->http://www.int/nmh/countries/nga-enpdf. Accessed on 15/07/2020.

Wolfrum S, Jensen KS, Liao JK. Endothelium-dependent effects of statins. Arterioscler Thromb Vasc Biol. 2003;23:729-36.

Nadruz W. Myocardial remodeling in Hypertension. J Human Hypertension. 2015;29:1-6.

Burchfield JS, Xie M, Hill JA. Pathological ventricular remodeling: Mechanisms. Circulation. 2013;128(4):388-400.

Marketou ME, Parthenakis F, Vardas PE. Pathological Left ventricular hypertrophy and stem cells: current evidence and new perspectives. Stem Cells Int. 2016;2016:5720758.

Opie LH, Comerford PJ, Gersh BJ, Pfeffer MA. Controversies in ventricular remodeling. Lancet. 2006;367:356-67.

Dobiasova M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size & esterification rate in apo B- lipoprotein depleted plasma. (FERHDL) Clin Biochem. 2001;34:583-8.

Osuji CU, Nzerem BA, Meludu S, Dioka CE, Nwobodo E, Amilo GI. The prevalence of overweight/obesity and dyslipidemia amongst a group of women attending ‘August’ meeting. Niger Med J. 2010;51:155-9.

Sani MU, Wahab KW, Yusuf BO, Gbadamosi M, Johnson OU, Gbadamosi A. Modifiable risk factors among apparently healthy adult Nigerian population- a cross- sectional study. BMC Research notes. 2013;3:11.

Odenigbo CU, Odenigbo UM, Oguejiofor OC, Okonkwo UC, Oguanobi NI. Prevalence of dyslipidemia in elderly subjects in Asaba, South-South Nigeria. J Indian Acad Geriatr. 2010;6:160-4.

Akintunde AA, Ayodele EO, Akinwusi OP, Opadijo GO. Dyslipidemia among newly diagnosed hypertensives: Pattern and clinical correlates. J Natl Med Assoc May. 2010;102:403-7.

Ojji DB, Ajayi SO, Mamven MH, Antherton J. Prevalence of dyslipidemia in normoglycemic subjects with newly diagnosed high blood pressure in Abuja Nigeria. J Clin Lipid. 2009;3:51-6.

Ogbera AO, Fasanmade OA, Chinenye S, Akinlade A. Characterization of lipid parameters in diabetes mellitus- a Nigerian report. Int Arch Med. 2009;2:19.

Horio T, Miyazato J, Kamide K, Takiuchi S, Kawano Y. Influence of low high-density lipoprotein cholesterol on left ventricular hypertrophy and diastolic dysfunction in essential hypertension. Am J Hypertens. 2003;16:938-44.

Anan F, Yonemochi J, Masaki T, Takahashi N, Fukunaga N, Teshima Y et al. High-density lipoprotein cholesterol and insulin resistance are independent and additive markers of left ventricular hypertrophy in essential hypertension. Hypertens Res. 2007;30(2):125-31.

Velagaleti RS, Pencina MJ, Vasan RS, Benjamin EJ, Massaro JM, Pencina K et al. Cross-sectional relations of lipid concentrations to left ventricular structural attributes. Am J Cardiol. 2010;105:1297-9.

Schillaci G, Vaudo G, Reboldi G, Verdecchia P, Lupattelli G, Pasqualini L, et al. High-density lipoprotein cholesterol and left ventricular hypertrophy in essential hypertension. J Hypertens. 2001;19(12):2265-70.

Nham E, Kim SM, Lee SC, Chang SA, Sung J, Cho SJ et al. Association of cardiovascular disease risk factors with left ventricular mass, biventricular function, and the presence of silent myocardial infarction on cardiac MRI in an asymptomatic population. Int J Cardiovasc Imaging. 2016;32:173-81.

Ferrara LA, Cardoni O, Mancini M, Zanchetti A. Metabolic syndrome and left ventricular hypertrophy in a general population. Results from the Gubbio study. J Hum Hypertens. 2007;21(10):795-801.

Jorgensen PG, Jensen MT, Biering-Sorensen T, Mogelvang R, Galatius S, Fritz-Hansen T et al. Cholesterol remnants and triglycerides are associated with decreased myocardial function in patients with type 2 diabetes. Cardiovasc Diabetol. 2016;15(1):137.

Bittner V, Johnson BD, Zineh I, Rogers WS, Vido D, Marroquin OC et al. The Triglyceride/High-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial: a report from the women’s ischemia syndrome evaluation (WISE). Am Heart J. 2009;157(3):548-55.

Ingelsson E, Schaefer EJ, Contois JH, McNamara JR, Sullivan L, Keyes MJ et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA. 2007;298(7):776-85.

Arsenault BJ, Rana JS, Stroes ES, Depres JP, Shah PK, Kastelin JJ et al. Beyond low-density lipoprotein cholesterol: respective contributions of non-high-density lipoprotein cholesterol levels, triglyceride and the total cholesterol/high-density lipoprotein cholesterol ratio to coronary heart disease risk in apparently healthy men and women. J Am Coll Cardiol. 2009;55(1):35-41.

Elshazly MB, Quispe R, Michos ED, Sniderman AD, Toth PP, Banach M et al. Patient-level discordance in population percentiles of the total cholesterol to high-density lipoprotein cholesterol ratio in comparison with low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol: the very large database of lipid study (VLDL-2B). Circulation. 2015;132(8): 667-76.

Mattews SC, Mallidi J, Kulkarni K, Toth PP, Jones SR. Achieving secondary prevention low—density lipoprotein particle concentration goals using lipoprotein cholesterol-based data. PLoS One. 2012;7(3):e33692

Salazar MR, Carbajal HA, Espeche WG, Balbin E, Dulbecco CA, Reaven GM et al. Relation among the plasma triglyceride/high-density lipoprotein cholesterol concentration ratio, insulin resistance, and associated cardio-metabolic risk factors in men and women. Am J Cardiol. 2012;109(12):1749-53.

Bhalokar NC, Blum S, Enas EA. Accuracy of the ratio of triglycerides to high-density lipoprotein cholesterol for predicting low-density lipoprotein cholesterol particle sizes, phenotype B, and particle concentrations among Asian Indians. Am J Cardiol. 2006;97(7):1007-9.

Wang H, Li Z, Guo X, Chen Y, Charg Y, Chen S. The impact of non-traditional lipid profiles on left ventricular geometric abnormalities in the general Chinese population. BMC Cardiovasc Disord. 2018;18:88.

Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285(19):2486- 97.

Ogah O.S, Bamigboye A.E. Correlates of left ventricular mass in hypertensive Nigerians: an echocardiographic study. Cardiovasc J. Afr. 2010;21(2):79-85.

Li L, Shigematsu Y, Hamada M, Hiwada K. Relative Wall Thickness Is an Independent Predictor of Left Ventricular Systolic and Diastolic Dysfunctions in Essential Hypertension. Hypert Res. 2001;24(5):493-9.

Adamu UG, Okuku GA, Oladele CO, Abdullahi A, Oduh JI, Fasae A. Serum lipid profile and correlates in newly presenting Nigerians with arterial hypertension. Vasc. Health Risk Manag. 2013;9:763-8.

Ogueiofor OC, Onwukwe CH, Odenigbo CU. Dyslipidemia in Nigeria: Prevalence and Pattern. Ann Afr Med. 2012;11:197-202.

Cockerill GW, Huehns TY, Weerasinghe A, Stocker C, Lerch PG, Miller NE et al. Elevation of plasma high-density lipoprotein concentration reduces interleukin-1 induced expression of E-selectin in an in-vivo model of acute inflammation. Circulation. 2001;103(1):108-12.

Velagaleti RS, Massaro J, Vasan RS, Robins SJ, Kannel WB, Levy D. Relations of lipid concentrations to heart failure incidence: the Framingham Heart Study. Circulation. 2009;120(23):2345-51.

Di Bonito P, Moio N, Scilla C, Cavuto L, Sibilio G, Saitta F et al. Usefulness of the high triglyceride to HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care. 2012;35(1):158-162.

Di Bonito P, Valerio G, Grugri G, Licenziati MR, Manco M, Tomat M, et al. Comparison of non-HDL- cholesterol versus triglycerides-to-DHL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight/obese children: the CARITALY study. Nutr Metab Cardiovasc Dis. 2015;25(5):489-94.

Sundstrom J, Lind L, Vessy B, Andren B, Aro A, Lithell H. Dyslipidemia and an unfavorable fatty acid profile predict left ventricular hypertrophy 20 years later. Circulation. 2001;103(6):836-41.

Nandeesha H, Pavithran P, Madanmohan T. Effect of antihypertensive therapy on serum lipids in newly diagnosed essential hypertensive men. Angiology. 2009;60(2):217-20.