Left ventricular hypertrophy in normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment

Background: Left ventricular hypertrophy (LVH) is an independent risk factor for myocardial ischaemia, cardiac arrhythmia, sudden death, and heart failure, all common findings in patients with type 2 diabetes. Aim: To determine the prevalence of, and risk factors for, LVH in normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment. Design: Cross-sectional study. Methods: From 1994 to 1998, M-mode echocardiography was performed by one experienced examiner in 262 consecutive, normoalbuminuric Caucasian type 2 diabetic patients, all with blood pressure <160/95 mmHg and not taking antihypertensive medication. Mean ± SD age was 54 ± 10 years, 109 were women, and median known duration of diabetes was 4 (range 1-28) years. Body mass index (BMI) was 28 ± 5 kg/m², and blood pressure 134 ± 13/79 ± 8 mmHg, all means ± SD. Median urinary albumin excretion rate was 9 (range 2-30) mg/24 h. Results: The prevalence of LVH indexed to height^2.7 was 43% (95% CI 38-50%), and was similar in men and women. BMI, HbA_1c and log urinary albumin excretion were significantly associated with left ventricular hypertrophy in a logistic regression model, whereas sex, age, known duration of diabetes and blood pressure were not. Similar results were obtained for left ventricular mass index. Discussion: LVH was frequent in our normoalbuminuric type 2 diabetic patients not taking antihypertensive treatment. Several potentially modifiable risk factors, such as raised BMI, poor glycaemic control and elevated urinary albumin excretion rate, were associated with LVH.