Hypertension 24 Background: This study investigated the impact of a putative functional TLR4 polymorphism (Asp299Gly) on 25 left ventricular (LV) structure in hypertensive subjects. 26 Methods: A sample of 443 patients (266 women and 177 men) was evaluated by clinical history, physical 27 examination, anthropometry, analysis of inflammatory and metabolic parameters, echocardiography and 28 TLR4 Asp299Gly genotyping. In addition, the relationship between the polymorphism and in vitro 29 lipopolysaccharide responsiveness of peripheral blood monocytic cells was also assessed. 30 Results: Women carrying the 299Gly allele presented lower posterior wall thickness (p = 0.01), 31 interventricular septum thickness (p = 0.04), LV mass (p = 0.01) and LV mass index (p = 0.03), as well as 32 a reduced prevalence of LV hypertrophy (p = 0.002), in comparison to women with the wild-type genotype. 33 These results were confirmed by stepwise and logistic regression analyses adjusted for potential 34 confounders. Conversely, the 299Gly allele did not influence LV structure in men. Furthermore, in vitro 35 assays revealed that monocytes of either men or women heterozygous for the 299Gly allele presented a 36 lower lipopolysaccharide-induced production of interleukin-6, compared to non-carriers. 37 Conclusions: The functional TLR4 Asp299Gly polymorphism is associated with lower LV mass in hypertensive 38 women. These findings suggest that interactions among gender, LV remodeling and TLR4 gene variants may 39 occur in hypertensive subjects. 40 © 2010 Published by Elsevier B.V. 41 42 43 44 45