Structural cardiac changes in relation to 24-h ambulatory blood pressure levels in borderline hypertension.
OBJECTIVE
To investigate left ventricular hypertrophy (LVH) in relation to 24-h ambulatory blood pressure (24-ABPM) and insulin levels in borderline hypertension.


METHODS
A case-control study.


METHODS
Borderline hypertensive men (diastolic blood pressure (DBP) 85-94 mmHg, n = 69) and age-matched normotensive controls (DBP < or = 80 mmHg, n = 69) from a population screening programme.


METHODS
Echocardiography (M-mode), insulin (RIA) and 24-APBM (Del Mar P-IV) levels.


RESULTS
The borderline group showed a significant increase in septal thickness (10.4 +/- 1.5 vs. 9.7 +/- 1.5 mm, P < 0.01), peak systolic wall stress (218 +/- 38 vs. 202 +/- 38 10(3) dynes cm-2, P < 0.05) and a decrease in LV ejection time (28.4 +/- 2.5 vs. 29.5 +/- 2.1s, P < 0.01). The septum vs. posterior wall thickness ratio was significantly higher in the borderline group (1.13 +/- 0.14 vs. 1.06 +/- 0.14, P < 0.01). Casual BP levels did not correlate with LVH indices, while 24-ABPM systolic levels correlated strongly with LVH indices in the borderline group (r = 0.22-0.52, P < 0.05) but not in the normotensive group. Insulin levels correlates strongly with LVH indices in the normotensive group (r = 0.34-0.47, P < 0.01) but not the borderline, group.


CONCLUSIONS
Signs of asymmetric LVH and altered ventricular function are already detectable in borderline hypertension. The data also suggest that early structural cardiac changes are related to ambulatory blood pressure profile, but not to casual blood pressure or trophic factors such as insulin.
Lemne
C
C
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
Lindvall
K
K
Georgiades
A
A
Fredrikson
M
M
de Faire
U
U
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D016277:Ventricular Function, Left / Q000502:physiology
D007328:Insulin