EFFECT OF AGING ON LEFT-VENTRICULAR FILLING IN UNTREATED HYPERTENSIVEPATIENTS

The aim of this study was to evaluate the influence of age and other c linical and echocardiographic parameters on left ventricular filling i n a group of 174 untreated patients with mild to moderate hypertension (aged 20-82 years; mean 51.2 years) and in 189 age-matched normotensi ve subjects. All subjects underwent an echocardiographic study with pu lsed Doppler evaluation of left ventricular filling, Left ventricular dimensions and indexes of systolic function were similar and within no rmal limits in both groups. Left ventricular filing was altered in hyp ertensive subjects < 65 years with a decrease of peak early velocity ( peak E), an increase of peak atrial velocity (peak A) and a reduced E/ A ratio, However in subjects greater than or equal to 65 years, we did not observe any differences in transmitral flow velocity pattern betw een hypertensive and normotensive subjects. The stepwise regression an alysis showed that age alone explains up to 8% of peak E variance, 14% of peak A and 26% of E/A ratio in hypertensives, while in normotensiv es it explains up to 18% of peak E variance, 50% of peak A and 61% of E/A ratio. The other variables entered into the regression slightly im proved the predictive power, In conclusion, age is the major independe nt factor affecting left ventricular filling in both groups, even if i ts predictive power was smaller in the hypertensive group. The similar ity of diastoiic filling pattern in elderly hypertensive and normotens ive subjects suggests that the 'aging factor' plays an important role in influencing left ventricular filling pattern so as to mask the effe ct of hypertension in the elderly patients.