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Left ventricular diastolic function and responses to adrenergic stimuli in borderline arterial hypertension
G Covi1, I Sheiban, G P Gelmini
1Clinica Medica, University of Verona, Italy.
Insights
Young individuals with borderline hypertension show early signs of reduced left ventricular compliance. This preclinical change in diastolic function correlates with blood pressure, even before hypertension is fully established.
Area of Science:
- Cardiology
- Hypertension Research
- Diastolic Function
Background:
- Arterial hypertension is a significant cardiovascular risk factor.
- Early detection of cardiac changes in preclinical hypertension is crucial.
- Adrenergic reactivity and left ventricular diastolic function (LVDF) are potential early indicators.
Purpose of the Study:
- To investigate the relationship between arterial hypertension, adrenergic reactivity, and LVDF.
- To assess if borderline hypertension is associated with altered diastolic function.
- To explore early preclinical changes in the left ventricle.
Main Methods:
- Study included 59 young subjects with borderline hypertension and 10 controls.
- Blood pressure was measured at baseline and during adrenergic stimuli (mental stress, handgrip, cold pressor).
- Left ventricular diastolic function (LVDF) was assessed using echocardiography in a subset of subjects.
Main Results:
- No significant differences in blood pressure response to adrenergic stimuli were found between borderline hypertensive and control groups.
- Echocardiographic indices of LVDF were significantly different in borderline hypertensive groups compared to controls.
- LVDF parameters correlated significantly with concurrent systolic and diastolic blood pressure.
Conclusions:
- Blood pressure response to adrenergic stimuli is similar in borderline and hypertensive groups.
- The correlation between blood pressure and LVDF suggests early-onset reduced left ventricular compliance.
- These findings may indicate preclinical changes in hypertension, even before overt disease manifestation.
Objective:
To detect the existence of a possible relationship between arterial hypertension and adrenergic reactivity to pressure stimuli, and changes in left ventricular diastolic function (LVDF).
Patients:
Fifty-nine young subjects with borderline arterial hypertension and ten sex- and age-matched controls were investigated. After three medical examinations, the subjects were divided into hypertensive and borderline groups on the basis of the blood pressure reading at visit 3. A complete echocardiographic study was performed in 25 of the 59 subjects.
Design:
Blood pressure was measured in baseline conditions and during pressure stimuli (mental stress, handgrip and cold pressor tests). LVDF was evaluated primarily by means of filling velocities during diastolic phases taken from the left ventricular volume curve (obtained from a complete echocardiographic study).
Results:
No significant changes in blood pressure responses were observed for the borderline or hypertensive groups during the adrenergic test. The echocardiographic indices of diastolic function were statistically different for the two groups when compared with the control group. The LVDF parameters correlated significantly with systolic blood pressure and diastolic blood pressure measured at the time of the echocardiogram, but not with blood pressure measured occasionally.
Conclusions:
Blood pressure increases similarly during adrenergic stimuli in both the hypertensive and borderline groups. The correlation between systolic blood pressure, diastolic blood pressure and LVDF parameters may indicate a very early onset of reduced compliance of the left ventricle, even in a preclinical phase of hypertension.