Correlation between Left Ventricular Mass Index and Calcium Metabolism in Patients with Essential Hypertension

摘要

Objective: To determine the correlation between left ventricular mass index and calcium metabolism in patients with essential hypertension. Study Design: Cross sectional case-control study. Material and Methods: Twenty-seven patients with essential hypertension and 20 healthy individuals were compared with respect to calciotropic hormones, left ventricular mass index (LVMI), and urinary and serum biochemical parameters. The correlations between parathormone, vitamin D, and calcitonin levels and LVMI and blood pressure elevation were determined. Results: The parathormone level was significantly higher (p=0.006) and vitamin D level was significantly lower (p=0.01) in the patient group compared with the control group. However, the two groups were similar in terms of albumin-corrected calcium levels, which were within the normal range (p=0.988). The serum sodium (p=0.014) and urinary calcium (p=0.003) levels and LVMI (p<0.01) were also significantly higher in the patient group. No significant correlations were determined between ambulatory blood pressure and parathormone and vitamin D levels, but a significant correlation was found between LVMI and parathormone level (p=0.06) in hypertensive patients. Conclusion: Essential hypertension alters calcium metabolism, causing calciuresis by hypernatremia. Parathormone release increases to compensate for this, and leads to protein synthesis, which in turn provokes the development of myocardial hypertrophy. Turkish Ba?l?k: Esansiyel Hipertansiyonlu Hastalarda Sol Ventrikül Kitle ?ndeksi ile Calsiyum Metabolizmas? Aras?ndaki Korelasyon Anahtar Kelimeler: Esansiyel hipertansiyon, sol ventrikül hipertrofisi, kalsiyum metabolizmas?, parathormon Ama?: Esansiyel hipertansiyonlu hastalarda sol ventrikül kitle indeksi ile kalsiyum metabolizmas? aras?ndaki korelasyonu ara?t?rmak Gere? ve Y?ntemler: Yirmiyedi esansiyel hipertansiyonlu ve 20 sa?l?kl? ?ah?s?n s?ras?yla kalsitropik hormonlar, sol ventrikül kitle indeksi (LVMI) ve idrar, serum biyokimyasal parametreleri kar??la?t?r?ld?. Parathormon, vitamin D, ve calcitonin düzeyleri, LVMI ve kan bas?nc? aras?ndaki korelasyonlar incelendi. Bulgular: Hasta grubunda; kontrol grubu ile kar??la?t?r?ld???nda parathormon düzeyi ?nemli ?l?üde yüksek ( p=0.006) ve vitamin D seviyesi ?nemli ?l?üde dü?üktü (p=0.01). Bununla beraber, iki grup albümine g?re düzeltilmi? kalsiyum düzeyleri bak?m?ndan benzerdi ve bu düzey normal s?n?rlar i?indeydi (p=0.988). Hasta grubunda serum sodyum ( p=0.014) ve üriner kalsiyum (p=0.003) düzeyleri ve LVMI (p<0.001) de ?nemli ?l?üde yüksekti. Hipertansif hastalarda ambulatuvar kan bas?nc?, parathormon ve vitamin D düzeyleri aras?nda ?nemli bir korelasyon saptanmad? fakat LVMI ve parathormon düzeyi (p=0.06) aras?nda ?nemli korelasyon bulundu. Sonu?: Esansiyel hipertansiyon hipernatremi nedeniyle kalsiüresise sebep olarak kalsiyum metabolizmas?n? de?i?tirir. Parathormon sal?n?m? bunu kompanse etmek i?in artar ve miyokardiyal hipertrofi geli?mesine yol a?an protein sentezine neden olur.