AMBULATORY BLOOD-PRESSURE MONITORING AND DIASTOLIC LEFT-VENTRICULAR ABNORMALITIES IN ESTABLISHED AND BORDERLINE HYPERTENSION

In order to evaluate left ventricular diastolic function by means of D oppler echocardiography in borderline and established hypertension, id entified by office and ABPM, compared with normotensives, 54 subjects: 15 normotensives, 11 borderlines and 28 nontreated mild to moderate e ssential hypertensives were studied. Age and weight were similar among groups. Established hypertensives showed higher left ventricular mass index (p < 0.05), peak velocity of late left ventricular filling (pea k A; p < 0.01), ratio peak A/peak velocity of early ventricular fillin g, peak E (p < 0.01), velocity time integral of systolic atrial volume (p < 0.001), deceleration half time of peak early diastolic in-flow v elocity (p < 0.05), left ventricular isovolumic relaxation period (IRP ; p < 0.01) than normotensives and lower Doppler indexes of early dias tolic left ventricular filling (p < 0.01), peak filling rate normalize d to mitral stroke volume (PFRn; p < 0.01) than normotensives. Althoug h borderline hypertensives showed intermediate LVM and Doppler indexes between hypertensives and normotensives only IRP (p < 0.05) and PFRn (p < 0.05) were significant different to normotensives. In conclusion, established hypertension leads to abnormalities in left ventricular. diastolic function which can be detected by Doppler echocardiography. In borderline hypertension, the left ventricular diastolic abnormaliti es are predominantly related to the active process of early diastole. Therefore, these indexes may be early markers of left ventricular dysf unction in hypertension.