PREVALENCE OF PHYSIOLOGICAL VALVULAR REGURGITATION IN HYPERTENSIVE PATIENTS - ECHOCARDIOGRAPHIC AND COLOR DOPPLER STUDY

Since the advent of the Doppler color flow echocardiography, the prese nce of a small degree of insufficiency of the cardiac valves has been detected with relative frequency in structurally and functionally norm al hearts. Data about this so-called 'physiological' regurgitation are presently available only in normotensive subjects and athletes. We th erefore studied the prevalence of this phenomenon in a group of patien ts with essential hypertension compared to a population of normotensiv e subjects. To this purpose, a Doppler color flow echocardiographic st udy was performed in 130 essential hypertensive patients (72M/58F; age 44.2 +/- 13.5 years; BP 154.3 +/-12.8/98.3 +/- 7.1 mm Hg) without any evidence of left ventricular hypertrophy or cardiopathy and in 100 no rmal subjects (59M/41F; age 41.2 +/- 14.8 years; BP 119.1 +/- 8.1/79.2 +/-8.1 mm Hg). We conclude that in patients with essential hypertensi on the physiological regurgitant jets are present in one or more cardi ac valves; moreover, the regurgitation of the mitral and aortic valve is found with more frequency than in the normotensive control group (3 6.1 vs. 27.0% and 17.7 vs. 11.0%, respectively). These data suggest th at the increased afterload of the left ventricle may play an important role in the pathogenesis of even minor degree of insufficiency of the cardiac valves. As this finding does not appear to have a pathologica l relevance, the main clinical implication of this study is that it is not advisable to create a jatrogenic heart disease in the hypertensiv e patients routinely screened by the echo-Doppler technique.