Organ damage in treated middle-aged hypertensives compared to normotensives: results from a cross-sectional study in general practice

Background: High blood pressure contributes to organ damage. However, durin g the past two decades there have been great advances in the medical treatm ent of hypertension. Technical progress has also made it easier to visualiz e organ damage. Hence we found it of interest to examine heart, brain and r etina in a group of middle-aged treated hypertensives, comparing the result s with those from a group of middle-aged normotensives. Methods: The subjec ts were 40 (20 men) treated hypertensives and 40 (20 men) normotensives, wh o had previously taken part in a study in which ambulatory blood pressure m onitoring had been performed. The heart was examined by echocardiography th e retina by photography and the brain by magnetic resonance imaging. Result s: Office blood pressure and 24-h systolic/diastolic blood pressure (S/D) w ere 141/86 (13/7) mmHg and 128/81 (11/6)mmHg in the hypertensives and 125/7 8 (10/8) mmHg and 118/74 (8/5) mmHg in the normotensives, respectively. Lef t ventricular mass was 101 (27) g/m(2) in the hypertensives and 85 (18) g/m (2) in the normotensives (p = 0.0025). The corresponding figures for the le ft atrium were 21.1 (3.1) mm/m(2) in the hypertensives and 19.5 (2.3) mm/m( 2) in the normotensives (p < 0.001). E/A wave quotient was 1.09 (0.26) in t he hypertensives and 1.26 (0.26) in the normotensives (p = 0.0045), while l eft ventricular systolic function did not differ between the groups. Ten hy pertensives and one normotensive subject had left ventricular mass above no rmal range. Narrow retinal arteries were found in 22 hypertensives and 8 no rmotensives (p < 0,001). Brain magnetic resonance changes (deep white matte r and/or periventricular) were: found in 19 hypertensives and 9 normotensiv es (p = 0.0431). Conclusions: The hypertensives differed significantly from the normotensives concerning left ventricular mass, left atrium, left vent ricular diastolic function and retinal vessel changes. Deep white matter an d periventricular changes in the brain were also significantly different in the two groups. We can only speculate as to whether earlier antihypertensi ve treatment or further blood pressure reduction could have affected these differences.