CHANGES IN CARDIAC DIASTOLIC DIMENSIONS PRECEDE HYPERTROPHY IN EARLY STAGES OF HYPERTENSION

Background: Left ventricular hypertrophy (LVH) has been identified as a main target organ change resulting from hypertension, also being a l ong-term predictor of myocardial infarction, stroke and cardiovascular death. However, very few longitudinal studies exist following the dev elopment of LVH in the hypertensive process. Methods: The present long itudinal study investigated a population based group of borderline hyp ertensive men (BHT, n=66, diastolic blood pressure (BP) 85-94 mm Hg). M-mode echocardiography was performed at baseline and after 3 years, a nd anthropometrical data recorded. Results: There was no increase in L VH indices over the 3-year period, while there was a statistically sig nificant increase in aortic root dimension (P < 0.001), left atrial di ameter in diastole (LADD, P < 0.001), left ventricular diameter in dia stole (LVDD, P < 0.001) and peak systolic wall stress (PSWS, P < 0.01) and a significant decrease in left ventricular ejection time (LVET, P < 0.01). Baseline BP levels correlated to PSWS (P < 0.05) but not to L VH indices, whereas body mass index (BMI) correlated significantly to wall thickness (P < 0.05) and LV mass (P < 0.05). Conclusions: LVH ind ices did not increase over a 3-year period. However, there was a signi ficant increase in aortic root dimension, LADD, LVDD and PSWS, and a s ignificantly shortened LVET, suggesting that these changes precede any increase in LVH. Finally, BMI showed stronger correlation to LVH indi ces than did BP levels.