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Abstract
Systemic hypertension is a common cause of congestive heart failure. However, left
ventricular (LV) systolic function remains normal for many years in patients with
mild or moderate hypertension. In this study, high-quality M-mode echocardiograms
were recorded in 7 patients with borderline hypertension, 14 patients with mild hypertension
and 15 normal persons. Measures of systolic and diastolic LV function and the degree
of LV hypertrophy were studied with the assistance of a tablet digitizer and dedicated
microcomputer. Average blood pressure was 125 ± 10/77 ± 7 mm Hg in normal subjects,
146 ± 18/92 ± 2 mm Hg in patients with borderline hypertension and 150 ± 11/102 ±
4 in patients with mild hypertension. Indexes of systolic LV function were similar
in all 3 groups. The peak rate of early relaxation of the LV posterior wall was significantly
decreased in the group of patients with mild hypertension (4.7 vs 6.6 sec−1, p < 0.01). The mitral valve closure rate was 150 ± 32 mm/s in normal subjects, 119
± 35 mm/s in patients with borderline hypertension and 106 ± 26 mm/s (p < 0.001) in
patients with mild hypertension. Mild LV hypertrophy was present in 6 of 7 patients
with borderline and 13 of 14 patients with mild hypertension. The degree of hypertrophy
and the level of blood pressure correlated poorly. It is concluded that subtle abnormalities
of diastolic LV function may be present in patients with mild hypertension at a time
when LV systolic function in normal and that the degree of hypertrophy and intermittent
measurements of blood pressure at rest correlated, poorly, suggesting that additional
factors may play a role.
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References
- Role of blood pressure in the development of congestive heart failure.N Engl J Med. 1972; 287: 781-787
- Cardiac load and function in hypertension: ultrasonic and hemodynamic study.Am J Cardiol. 1979; 44: 1007-1012
- Left ventricular performance in patients with left ventricular hypertrophy caused by systemic hypertension.Br Heart J. 1977; 39: 1239-1245
- Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects.Circulation. 1979; 59: 623-632
- Abnormal left ventricular relaxation in hypertensive patients.Clin Sci. 1980; 59: 411S-414S
- Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension.Am J Cardiol. 1984; 53: 120-126
- Echocardiographic features of malignant hypertension.Br Heart J. 1981; 46: 374-379
- Relation of hemodynamic load to left ventricular hypertrophy and performance in hypertension.Am J Cardiol. 1983; 51: 171-176
- Left ventricular hypertrophy in patients with hypertension: importance of blood pressure response to regularly recurring stress.Circulation. 1983; 68: 470-476
- Reversal of left ventricular hypertrophy with methyldopa.Am J Cardiol. 1982; 49: 795-801
- Echocardiographic studies of left ventricular anatomy and function in essential hypertension.Cardiovasc Med. 1977; 2: 477-491
- Echocardiographic measurements in normal subjects: growth-related changes that occur between infancy and early adulthood.Circulation. 1978; 57: 278-285
- Echocardiographic measurements in normal subjects. Evaluation of an adult population without clinically apparent heart disease.J Clin Ultrasound. 1979; 7: 439-447
- Analysis of left ventricular motion by reflected ultrasound: application to assessment of myocardial function.Circulation. 1972; 46: 14-25
- Left ventricular relaxation, mitral valve proplapse, and intracardiac conduction in myotonia atrophica: assessment by digitized echocardiography and noninvasive His bundle recording.Am Heart J. 1982; 104: 77-85
- Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy: an echocardiographic study.Am J Cardiol. 1980; 45: 15-23
- Echocardiographic diastolic ventricular abnormality in hypertensive heart disease: atrial emptying index.Am J Cardiol. 1981; 47: 1087-1090
- Failure of antihypertensive therapy with diuretic, beta-blocking and calcium-channel blocking drugs to consistently reverse left ventricular diastolic filling abnormalities.Am J Cardiol. 1984; 53: 1583-1587
- Clinical correlates in hypertensive patients with left ventricular hypertrophy diagnosed with echocardiogram.Am J Cardiol. 1981; 47: 334-341
- Blood pressure and hypertensive disease among negroes and whites.Ann Intern Med. 1964; 61: 208-228
- Race, education and prevelance of hypertension.Am J Epidimiol. 1977; 106: 351-361
- Racial differences in cardiac adaptation to essential hypertension determined by echocardiographic indexes.JACC. 1983; 1: 1348-1351
- Myocardial hypertrophy and cardiac failure: A complex inter-relationship.Am J Med. 1983; 75 (suppl): 67-74
- Is arterial pressure the sole factor responsible for hypertensive cardiac hypertrophy?.Am J Cardiol. 1979; 44: 959-963
- Plasma norepinephrine and left ventricular hypertrophy in systemic hypertension.Am J Cardiol. 1984; 53: 1299-1303
- Myocardial hypertrophy produced by chronic subhypertensive doses of norepinephrine in the dog.Chest. 1976; 64: 75
Article Info
Publication History
Accepted:
May 7,
1985
Received in revised form:
May 6,
1985
Received:
February 25,
1985
Identification
Copyright
© 1985 Published by Elsevier Inc.