A study on the prevalence of increased left ventricular mass and proteinuria in newly diagnosed hypertensive patients

Introduction: Hypertension is a major cause of morbidity and mortality. The heart, arterial vessels, brain, kidney and retinal vasculature are major target organs adversely affected by high blood pressure. In adults there is a continuous incremental risk of target organ damage across levels of both systolic and diastolic blood pressure. Cardio vascular disease risk doubles for every 20mmHg systolic and 10mm Hg diastolic rise in blood pressure. Aim of the study: To study different cardiac geometry in newly diagnosed hypertensives and to correlate proteinuria and LV mass in hypertensives. Materials and methods: Fifty newly registered patients at Government Dharmapuri Medical College Hospital from October 2016 - April 2017 were included in the study. In all these patients, history of substance abuse, comprehensive clinical examination and appropriate imaging and bio-chemical evaluation done. Results: Patient distribution between stage I and stage II hypertensives were almost equal. Among the distribution of patients with pulse pressure gradient, 20 patients (40%) had pulse pressure in the range of 41-50, 15 patients (30%) had pulse pressure in the range of 51-60. 7 (14%) and 8 (16%) had pulse pressure below 40 and above 60 respectively. In the study, 18 patients (36%) had urine protein in Mircoproteinuria range as detected by early morning spot urine protein - creatinine ratio. Among 18 patients with Micro- Proteinuria, 15 patients (83%) had abnormal cardiac geometry. Among 26 patients with abnormal cardiac geometry, 15 patients (58%) had micro proteinuria. There is significant association between microproteinuria and abnormal cardiac geometry in patients with essential hypertension. Conclusion: A significant association was seen between widened pulse pressure and LVH Majority of patients with pulse pressure above 50 had LVH. While most of the patients with pulse pressure < 50 had normal geometry. Majority of patients (70%) with proteinuria and LVH were in stage-II hypertension. Patients were almost equally distributed between stage I and II Hypertension. Majority of patients had normal cardiac geometry in stage I while stage II patients had LVH of whom majority had microproteinuria.