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

J Hum Hypertens. 1998 Oct;12(10):679-83. doi: 10.1038/sj.jhh.1000690.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Body Mass Index
  • Diastole
  • Echocardiography*
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnostic imaging*
  • Hypertension / pathology
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / etiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Smoking