Left ventricular diastolic function in essential hypertensive patients: influence of age and left ventricular geometry.
OBJECTIVE
To evaluate diastolic dysfunction (DD) in essential hypertension and the influence of age and cardiac geometry on this parameter.


METHODS
Four hundred sixty essential hypertensive patients (HT) underwent Doppler echocardiography to obtain E/A wave ratio (E/A), atrial deceleration time (ADT), and isovolumetric relaxation time (IRT). All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy) and to age (<40; 40 - 60; >60 years). One hundred six normotensives (NT) persons were also evaluated.


RESULTS
A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38+/-0.03 vs HT - 1.27+/-0.02, p<0.01), was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR). Multiple regression analysis identified age as the most important predictor of DD (r2=0.30, p<0.01).


CONCLUSIONS
DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.
Rosa
Eduardo Cantoni
EC
Division of Nephrology, Kidney and Hypertension Hospital, Universidade Federal de São Paulo.
Moysés
Valdir Ambrósio
VA
Rivera
Ivan
I
da Cintra Sesso
Ricardo
R
Kohlmann
Nárcia
N
Zanella
Maria Tereza
MT
Ribeiro
Artur Beltrame
AB
Kohlmann
Osvaldo
O
D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology*; D020257:Ventricular Remodeling