ASSOCIATION BETWEEN THE BLOOD-PRESSURE AND CIRCULATING HORMONAL FACTORS WITH THE LEFT-VENTRICULAR MASS IN ESSENTIAL HYPERTENSIVE PATIENTS OLDER THAN 55 YEARS

BACKGROUND: The prevalence of left ventricular hypertrophy (LVH) is hi gher in elderly patients with hypertension than in normotensive patien ts, The factors relationed herewith are not well known, The first purp ose was to analyse the relationship between the levels of blood pressu re (BP) recorded by ambulatory blood pressure monitoring (ABPM) and th e left ventricular mass index (LVMI) in a group of untreated patients older than 55 years with essential hypertension. Our second purpose wa s to observe the relationship between the concentration of several cir culating hormones and the left ventricular mass index, SUBJECTS AND ME THODS: The study included 31 untreated patients with mild to moderate essential hypertension and 37 healthy normotensives. Both groups were of similar age, sex and body mass index. We determined for both groups the casual arterial pressure (CAP), ambulatory BP monitoring (ABPM) t hroughout 24 h, daytime (07.00-23.00 h), nighttime (23.00-07.00 h): le ft ventricular mass index (LVMI) (following Devereux's formula) and ci rculating levels of endothelin-1, aldosterone, renine, free adrenaline and noradrenaline, RESULTS: The ILVM in hypertensive patients was 139 .6 +/- 35.9 g/m(2) and in 124.0 +/- 31.8 g/m(2) in normotensive (p < 0 .05), The percentage of patients with LVH was 63 and 43%, respectively (p < 0.05). The LVMI in hypertensive patients was correlated with the diastolic CAP (97 +/- 7 mmHg) (r = 0.41; p < 0.05), unlike with the s ystolic CAP (164 +/- 18 mmHg), The ILVM in normotense patients was not associated neither with the systolic CAP (126 +/- 10 mmHg) nor with t he diastolic (79 +/- 6 mmHg). In hypertensive patients we found a slig ht association between the LVMI and the systolic ABPM (130 +/- 14 mmHg ) during nighttime (r = 0.41; p < 0.05), The rest of average ambulator y BP and the hormonal values at study did not show a correlation with the LVMI in both groups. CONCLUSIONS: A Slight correlation exists betw een BP (casual and determined with ambulatory blood pressure monitorin g throughout 24 hours) and the left ventricular mass index in mild to moderate untrated hypertensive patients older than 55 years, We did no t observe correlations between the circulating levels of endothelin-l, renin, aldosterone, free adrenaline and noradrenaline and the left ve ntricular mass, The average ventricular mass and the number of subject s with ventricular hypertrophy was significantly increased in hyperten sives than in normotensives.