GLUCOSE-INTOLERANCE EXAGGERATES LEFT-VENTRICULAR HYPERTROPHY AND DYSFUNCTION IN ESSENTIAL-HYPERTENSION

The influence of glucose intolerance, the preclinical stage of diabete s mellitus, on the progression of left ventricular hypertrophy and lef t ventricular dysfunction in essential hypertension, was assessed with two-dimensional M-mode echocardiography in age- and sex-matched essen tial hypertensive patients with (n = 28) or without (n = 44) glucose i ntolerance, and normotensive control subjects (n = 29). Left ventricul ar mass index in hypertensive patients with glucose intolerance was si gnificantly higher than that in hypertensive patients without glucose intolerance (mean +/- SD, 115.6 +/- 28.2 v 102.1 +/- 22.1 g/m(2); P <. 05). Left ventricular diastolic function as reflected by peak lengthen ing rate was reduced in glucose-intolerant hypertensive patients than in hypertensive patients without glucose intolerance (2.68 +/- 0.71 v 3.16 +/- 0.82 /sec; P <.05). End-systolic wall stress/left ventricular end-systolic volume index, an index of left ventricular contractility , was reduced more in glucose-intolerant hypertensive patients than in hypertensive patients without glucose intolerance (2.75 +/- 0.55 v 3. 13 +/- 0.55 10(3) dyn.m(2)/cm(2).mL(-1); P <.01). These findings sugge st that glucose intolerance accelerates progression of left ventricula r hypertrophy and deteriorates left ventricular diastolic function and contractility in essential hypertension.