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Pulse pressure and left ventricular diastolic dysfunction in hypertensive patients

Chrysanthi O Trika1, Nikolaos Zakopoulos, Savvas T Toumanidis

  • 1Department of Clinical Therapeutics, Medical School, University of Athens, Alexandra Hospital, Athens, Greece.

Cardiology
|May 1, 2004
PubMed

Insights

In elderly hypertensive patients without left ventricular hypertrophy, high nighttime pulse pressure predicts abnormal diastolic filling. This finding aids in understanding hypertension

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diastology

Background:

  • Essential hypertension frequently leads to impaired left ventricular diastolic function.
  • Left ventricular diastolic function is assessed using the E/A flow velocity index.
  • Age and left ventricular hypertrophy are known factors influencing diastolic function.

Purpose of the Study:

  • To investigate the relationship between 24-hour blood pressure and heart rate variations and mitral valve flow velocity (E/A).
  • To identify predictors of impaired left ventricular diastolic function in hypertensive patients across different age groups and with or without left ventricular hypertrophy.

Main Methods:

  • Doppler echocardiography and ambulatory blood pressure monitoring were used in 198 patients with mild to moderate essential hypertension.
  • Patients were stratified by age (40-54 and 55-79 years) and presence of left ventricular hypertrophy.
  • Multivariate stepwise regression analysis identified independent predictors of E/A.

Main Results:

  • In the overall population, age, posterior wall thickness, and daytime mean heart rate predicted E/A.
  • In young hypertensive patients with left ventricular hypertrophy, nighttime systolic blood pressure was the sole predictor of E/A.
  • In elderly hypertensive patients without left ventricular hypertrophy, daytime mean heart rate and nighttime mean pulse pressure were significant predictors of E/A.

Conclusions:

  • Nighttime pulse pressure is a significant independent predictor of abnormal left ventricular diastolic filling in elderly hypertensive individuals without left ventricular hypertrophy.
  • This finding offers a novel clinical marker for diastolic dysfunction in a specific hypertensive subgroup.
Abstract

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