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Left ventricular diastolic function in essential hypertensive patients: influence of age and left ventricular
Eduardo Cantoni Rosa1, Valdir Ambrósio Moysés, Ivan Rivera
1Division of Nephrology, Kidney and Hypertension Hospital, Universidade Federal de São Paulo.
Insights
Diastolic dysfunction (DD) is common in essential hypertension, worsening with age. Early detection of DD in hypertension is crucial for risk stratification.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Diastolic dysfunction (DD) is an early indicator of hypertensive heart disease.
- Understanding DD's progression is key for patient management.
Purpose of the Study:
- To assess diastolic dysfunction (DD) in essential hypertension.
- To investigate the impact of age and cardiac geometry on DD.
- To evaluate DD in early stages of hypertensive heart disease.
Main Methods:
- Doppler echocardiography was used to measure E/A ratio, ADT, and IRT in 460 hypertensive (HT) and 106 normotensive (NT) patients.
- Patients were categorized by cardiac geometry (normal, concentric remodeling, concentric hypertrophy, eccentric hypertrophy) and age groups.
- Statistical analysis, including multiple regression, was performed to identify predictors of DD.
Main Results:
- Hypertensive patients showed significantly worse diastolic function compared to normotensive individuals.
- Prevalence of DD increased with age and was present even in pre-hypertrophic stages (concentric remodeling).
- Age was identified as the strongest predictor of diastolic dysfunction (r2=0.30, p<0.01).
Conclusions:
- Diastolic dysfunction is highly prevalent in essential hypertension.
- Age significantly influences DD, more so than cardiac structural changes.
- Early detection of DD in hypertensive patients aids in risk stratification and management.
Purpose:
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).
Conclusion:
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.