LEFT-VENTRICULAR DIASTOLIC FUNCTION AND RESPONSES TO ADRENERGIC STIMULI IN BORDERLINE ARTERIAL-HYPERTENSION

Objective: To detect the existence of a possible relationship between arterial hypertension and adrenergic reactivity to pressure stimuli, a nd changes in left ventricular diastolic function (LVDF). Patient: Fif ty-nine young subjects with borderline arterial hypertension and ten s ex- and age-matched controls were investigated. After three medical ex aminations, the subjects were divided into hypertensive and borderline groups on the basis of the blood pressure reading at visit 3. A compl ete echocardiographic study was performed in 25 of the 59 subjects. De sign: Blood pressure was measured in baseline conditions and during pr essure stimuli (mental stress, handgrip and cold pressor tests). LVDF was evaluated primarily by means of filling velocities during diastoli c phases taken from the left ventricular volume curve (obtained from a complete echocardiographic study). Results: No significant changes in blood pressure responses were observed for the borderline or hyperten sive groups during the adrenergic test. The echocardiographic indices of diastolic function were statistically different for the two groups when compared with the control group. The LVDF parameters correlated s ignificantly with systolic blood pressure and diastolic blood pressure measured at the time of the echocardiogram, but not with blood pressu re measured occasionally. Conclusions: Blood pressure increases simila rly during adrenergic stimuli in both the hypertensive and borderline groups. The correlation between systolic blood pressure, diastolic blo od pressure and LVDF parameters may indicate a very early onset of red uced compliance of the left ventricle, even in a preclinical phase of hypertension.