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Similar effects of isolated systolic and combined hypertension on left ventricular geometry and function: the LIFE

V Papademetriou1, R B Devereux, P Narayan

  • 1Veterans Administration Medical Center, Washington, DC 20422, USA. papavp@aol.com

American Journal of Hypertension
|August 11, 2001
PubMed

Insights

Systolic blood pressure is a key driver of cardiac damage in hypertension. Even with lower mean arterial pressure, isolated systolic hypertension causes severe left ventricular abnormalities, similar to combined hypertension.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Isolated systolic hypertension (ISH) and combined systolic-diastolic hypertension (cHTN) are common cardiovascular conditions.
  • Left ventricular hypertrophy (LVH) is a significant predictor of cardiovascular events in hypertensive patients.
  • Understanding the differential impact of hypertension types on cardiac structure and function is crucial for risk stratification.

Purpose of the Study:

  • To compare cardiac abnormalities in patients with isolated systolic hypertension versus combined hypertension.
  • To identify determinants of left ventricular mass and relative wall thickness in hypertensive individuals.
  • To evaluate the role of systolic blood pressure as a determinant of cardiac target organ damage.

Main Methods:

  • Echocardiographic analysis of 143 patients with ISH and 808 patients with cHTN, all off medication and with LVH.
  • Comparison of demographic, blood pressure, and echocardiographic parameters between the two groups.
  • Multiple regression analyses to identify independent correlates of left ventricular mass and relative wall thickness.

Main Results:

  • Patients with ISH were older, shorter, lighter, and predominantly female, with similar BMIs to cHTN patients.
  • Despite lower mean arterial pressure, ISH patients exhibited comparable LVH severity, geometric patterns, and systolic/diastolic dysfunction as cHTN patients.
  • Systolic blood pressure, not ISH itself, was an independent correlate of LVH, while ISH was associated with increased relative wall thickness.

Conclusions:

  • Systolic blood pressure is a stronger determinant of cardiac target organ damage than diastolic pressure in hypertension.
  • Isolated systolic hypertension, despite lower mean pressures, leads to significant left ventricular abnormalities.
  • Relative wall thickness is independently associated with isolated systolic hypertension, suggesting distinct pathophysiological mechanisms.

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