Left ventricular hypertrophy in hypertensive patients with autosomal dominant polycystic kidney disease: Influence of blood pressure and humoral and neurohormonal factors

Left ventricular hypertrophy (LVH) is a common finding in hypertensive auto somal dominant polycystic kidney disease (ADPKD) patients. There are few st udies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relations hip between BP, humoral and neurohormonal factors and left ventricular mass (LVM) in hypertensive ADPKD patients, in 20 hypertensive ADPKD patients, a mbulatory BP was monitored far 24 h, left ventriclar dimensions were estima ted by echocardiography, and plasma renin activity (PRA), plasma noradrenal ine (NA), angiotensin II (Ang II), aldosterone, atrial natriuretic peptide (ANP) and insulin-like growth factor I (IGF-I) were also determined. Twenty age- and sex-matched essential hypertensive subjects served as controls. A mbulatory BP and LVM index were similar in the two groups, although male AD PKD patients had higher LVM indices than their matched controls. Eight ADPK D patients (40%) and 6 essential hypertensives (30%) showed LVH. PRA, Ang I I, aldosterone, ANP and IGF-I levels were similar in the two groups, but pl asma NA levels were higher in ADPKD patients than in controls (281 +/- 158 vs. 160 +/- 62 pg/ml, p = 0.004). ADPKD patients with LVH did not differ fr om those without LVH with regard to humoral and neurohormonal parameters, b ut had higher ambulatory BP levels. In ADPKD patients, correlation analysis revealed a significant association between LVM index and 24-hour systolic and diastolic BP, but not with any of the hormonal factors evaluated. On mu ltiple regression analysis, 24-hour diastolic BP was the only independent v ariable linked to LVM index. In conclusion, ambulatory BP is one of the mos t important determinants of LVM in hypertensive ADPKD patients. Further stu dies are warranted to elucidate the role of nonhemodynamic factors in the p athogenesis of LVH in this population. Copyright (C) 2000 S. Karger AG, Bas el.