Impact of age on left ventricular geometry and diastolic function in elderly patients with treated hypertension.
OBJECTIVE
Left ventricular (LV) remodelling is observed in numerous patients with hypertension and is a principal cause of heart failure in elderly patients. The aim of this study was to determine the relationships between age and structural/functional LV remodelling observed in elderly hypertensive patients.


METHODS
A total of 557 elderly hypertensive patients (mean age: 74.0 ± 8.6 years) with preserved LV systolic function underwent echocardiography and 24-hour blood pressure (BP) measurement.


RESULTS
Overall, 41.1% of patients had LV hypertrophy, 77.9% had increased relative wall thickness (RWT) defined as RWT >0.42, and 31.8% had both. Logistic analysis of the entire study population showed that increased RWT was associated with both 24-hour systolic BP (odds ratio (OR) 1.38, 95% confidence interval (CI) 1.12 to 1.70) and age (OR 1.32, 95%CI 1.08 to 1.61), whereas increased RWT was associated only with age (OR 1.61, 95%CI 1.23 to 2.11) after excluding patients with LV hypertrophy. Univariate and multivariate linear regression analyses of all patients showed that LV diastolic echocardiographic parameters were consistently associated with age (p ≤ .001) alone, even considering LV structural changes.


CONCLUSIONS
Age was independently correlated with LV concentric/functional changes regardless of LV hypertrophy, suggesting that ageing is independently involved in the progression of LV remodelling.
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.|b Division of Geriatrics and Vascular Medicine , Tokyo Medical and Dental University Hospital , Tokyo , Japan.
Ayumi
A
Toba
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Taro
T
Kariya
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Rie
R
Aoyama
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Taizo
T
Ishiyama
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Yusuke
Y
Tsuboko
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Kazuhiro
K
Takeda
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Hajime
H
Fujimoto
b Division of Geriatrics and Vascular Medicine , Tokyo Medical and Dental University Hospital , Tokyo , Japan.
Kentaro
K
Shimokado
a Division of Cardiology , Tokyo Metropolitan Geriatric Hospital , Tokyo , Japan.
Kazumasa
K
Harada
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003971:Diastole; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies
Diastolic function; heart failure; hypertension; left ventricular remodelling; relative wall thickness