Changes in cardiac diastolic dimensions precede hypertrophy in early stages of hypertension

Abstract

Background: Left ventricular hypertrophy (LVH) has been identified as a main target organ change resulting from hypertension, also being a long-term predictor of myocardial infarction, stroke and cardiovascular death. However, very few longitudinal studies exist following the development of LVH in the hypertensive process.

Methods: The present longitudinal study investigated a population based group of borderline hypertensive men (BHT, n = 66, diastolic blood pressure (BP) 85–94 mm Hg). M-mode echocardiography was performed at baseline and after 3 years, and anthropometrical data recorded.

Results: There was no increase in LVH indices over the 3-year period, while there was a statistically significant increase in aortic root dimension (P < 0.001), left atrial diameter in diastole (ladd, P < 0.001), left ventricular diameter in diastole (lvdd, P < 0.001) and peak systolic wall stress (psws, P < 0.01) and a significant decrease in left ventricular ejection time (lvet, P < 0.01). baseline bp levels correlated to psws (P < 0.05) but not to lvh indices, whereas body mass index (bmi) correlated significantly to wall thickness (P < 0.05) and lv mass (P < 0.05).

Conclusions: LVH indices did not increase over a 3-year period. However, there was a significant increase in aortic root dimension, LADD, LVDD and PSWS, and a significantly shortened LVET, suggesting that these changes precede any increase in LVH. Finally, BMI showed stronger correlation to LVH indices than did BP levels.