Changes in cardiac diastolic dimensions precede hypertrophy in early stages of hypertension.
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.
Lemme
C
C
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Lindvall
K
K
de Faire
U
U
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003971:Diastole; D004452:Echocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012907:Smoking