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Published on: April 30, 2020

[Abnormal patterns of diurnal blood pressure variation and cardiovascular remodeling in elderly hypertensive

Kazumasa Harada1

  • 1Division of Cardiology, Faculty of Medicine, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|September 11, 2007
PubMed

Insights

Brain natriuretic peptide (BNP) may indicate organ damage in elderly hypertension patients. Nocturnal blood pressure significantly impacts left ventricular hypertrophy, particularly in men, while women show accelerated cardiac remodeling with aging.

Area of Science:

  • Cardiovascular Medicine
  • Gerontology
  • Hypertension Research

Context:

  • Aging and hypertension are significant risk factors for cardiovascular disease.
  • Elderly hypertensive patients exhibit left ventricular hypertrophy and increased arterial stiffness.
  • Understanding sex-differences in cardiovascular remodeling is crucial for effective management.

Purpose:

  • To investigate cardiovascular remodeling in elderly hypertensive patients.
  • To analyze the influence of aging and sex on hypertension-related cardiovascular changes.
  • To explore the relationship between blood pressure, cardiac biomarkers, and vascular stiffness.

Summary:

  • Left ventricular mass index (LVMI) and pulse wave velocity (PWV) correlated with nocturnal blood pressures, which also correlated with brain natriuretic peptide (BNP) levels.
  • Nocturnal blood pressure, rather than aging itself, was a key determinant of left ventricular hypertrophy.
  • Cardiac remodeling (LVMI) and vascular remodeling (PWV) progressed with aging but appeared relatively independent of each other.

Impact:

  • BNP may serve as a surrogate endpoint for target organ damage in elderly hypertensive individuals.
  • Accelerated left ventricular hypertrophy in aging women, potentially linked to higher post-menopausal systolic blood pressure, may contribute to greater mortality.
  • Findings highlight the importance of nocturnal blood pressure monitoring and sex-specific considerations in managing hypertension in the elderly.

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