Left Ventricular Hypertrophy was Infrequent in Patients Staning Dialysis after Undergoing a Strict Blood Pressure Control in the Pre-dialytic Period

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  • NAKAZATO Takashi
    The Department of Internal Medicine, Sakura National Hospital
  • KAWADA Takayuki
    The Department of Internal Medicine, Kimitsu Chu-o Hospital
  • SHIGEMATSU Takashi
    The Department of Nephrology & Hypertension, Aoto General Hospital, Jikei University School of Medicine
  • YAMADA Kenichi
    The Department of Internal Medicine, Sakura National Hospital

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  • Left Ventricular Hypertrophy was Infrequent in Patients Starting Dialysis after Undergoing a Strict Blood Pressure Control in the Pre-dialytic Period.

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Objective We retrospectively investigated the factors influencing the left ventricular hypertrophy (LVH) occurrence in patients with chronic renal failure (CRF).<br> Methods and Patients Blood pressure and echocardiographyically determined LVH were assessed in 110 patients on the basis of availability of monthly follow-up data obtained during the period of 2 years before the start of dialysis. When the patients showed the left ventricular mass index of not less than 125 g/m2, they were diagnosed as having LVH. Mean casual blood pressure distribution was classified into 5 groups: Group 1; <93 mmHg, Group 2; 93-100 mmHg, Group 3; 100-106 mmHg, Group 4; 106-114 mmHg and Group 5; >114 mmHg.<br> Results LVH frequencies were 31.8, 72.7, 72.7, 81.8 and 95.5 (%) in Groups 1-5, respectively. Logistic regression showed that the factors influencing the progression of LVH were the duration of hypertension (per 1 year relative risk) (RR) 1.13, 95% confidential interval (CI) (1.01-1.26), treatment with angiotensin-converting enzyme inhibitors (ACE-I) (RR: 0.20, 95%CI: 0.04-0.99), pulse pressure (RR: 1.06, 95%CI: 1.00-1.11) and mean blood pressure (MBP). The RR of developing LVH increased progressively as MBP increased: Compared with LVH frequency in Group 1, RR of Group 2 was 4.38 (95%CI: 1.05-18.19), that of Group 3 was 5.50 (95%CI: 1.08-28.02), that of Group 4 was 5.66 (95%CI: 1.22-26.15), and that of Group 5 was 19.13 (95%CI: 1.75-209.4).<br> Conclusion Strict blood pressure control and ACE-I treatment could prevent LVH in patients with CRF.<br>(Internal Medicine 41: 925-930, 2002)

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  • Internal Medicine

    Internal Medicine 41 (11), 925-930, 2002

    一般社団法人 日本内科学会

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