Diastolic dysfunction and baroreflex sensitivity in hypertension

Citation
Mv. Pitzalis et al., Diastolic dysfunction and baroreflex sensitivity in hypertension, HYPERTENSIO, 33(5), 1999, pp. 1141-1145
Citations number
21
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
HYPERTENSION
ISSN journal
0194911X → ACNP
Volume
33
Issue
5
Year of publication
1999
Pages
1141 - 1145
Database
ISI
SICI code
0194-911X(199905)33:5<1141:DDABSI>2.0.ZU;2-F
Abstract
The determinants of diastolic dysfunction in patients with systemic hyperte nsion are not completely known. To evaluate the possible role of age, arter ial blood pressure, and baroreflex heart rate response impairment in causin g diastolic dysfunction, we studied 61 patients (42 male; mean+/-SD age, 43 .9+/-12 years) with newly recognized and therefore previously untreated sys temic hypertension, Diastolic dysfunction was evaluated by means of Doppler echocardiography (and diagnosed as such when the early to atrial peak velo city ratio corrected to heart rate was <1), arterial blood pressure by 24-h our ambulatory monitoring, and baroreflex heart rate response by means of t he spectral technique (alpha index) during paced (0.27 Hz) and spontaneous breathing (in a supine position and during tilt). Nineteen patients had dia stolic dysfunction, the most powerful predictor of which was age (r=-0.63, P<0.001). The patients with diastolic dysfunction had significantly lower v alues for spectral baroreflex gain in the high-frequency band than those wi thout (5.2+/-3 versus 8.4+/-5 ms/mm Hg during paced breathing, P<0.05; 7.4/-4 versus 13.3+/-7 ms/mm Hg in a supine position, P<0.05; 4.3+/-4 versus 5 +/-2 ms/mm Hg during tilt, P<NS). Ambulatory blood pressure values were not significantly different in the patients with (137+/-14 and 89+/-9 mm Hg) a nd without (144+/-11 and 82+/-24 mm Hg) diastolic dysfunction. In conclusio n, age and impaired baroreflex heart rate response (but not pressure overlo ad) are determinants of left ventricular diastolic dysfunction in patients with newly recognized and untreated systemic hypertension.