SUPERNORMAL LEFT-VENTRICULAR PERFORMANCE IN YOUNG SUBJECTS WITH MILD HYPERTENSION - AN ALERTING RESPONSE TO THE ECHOCARDIOGRAPHIC PROCEDURE

1. To assess the clinical significance of supernormal left ventricular systolic function in the initial phase of hypertension, 635 never-tre ated 18-45-year-old borderline to mild hypertensive subjects (477 male s, 158 females) were studied, All subjects underwent echocardiography, 24 h ambulatory blood pressure monitoring and 24 h urine collection f or catecholamine dosage. 2. Subjects whose left ventricular shortening -stress relationship was above the 95% confidence intervals of 50 norm otensive subjects of similar age and sex distribution were defined as having supernormal function. 3. Age, duration of hypertension and left ventricular mass were similar in the hypertensive subjects with norma l (85%) and supernormal (15%) ejective performance, Subjects with supe rnormal function showed higher office systolic blood pressure (P<0001) , office heart rate (P=0.03) and cardiac index (P<0001). Conversely, 2 411 systolic blood pressure, 2411 heart rate and 2411 catecholamine ou tput did not differ according to left ventricular function. 4. In conc lusion, the greater white-coat effect and the normal baseline sympathe tic tone exhibited by the patients with increased performance suggest that supernormal left ventricular pump function is only a marker of th e alerting reaction elicited by the echocardiographic examination.