Similar effects of isolated systolic and combined hypertension on left ventricular geometry and function: The LIFE study

Echocardiograms of 143 patients with isolated systolic hypertension were co mpared to 808 patients with combined (systolic and diastolic) hypertension. All patients met electrocardiographic criteria for left ventricular hypert rophy and were evaluated off medication. Patients with isolated systolic hy pertension were older, shorter, weighed less. and were mostly women, but bo dy mass index (BMI) was similar in both groups. Systolic blood pressure (SB P) was 172 mm Hg in isolated systolic hypertension, 174 mm Hg in combined ( P = not significant). Diastolic blood pressure was 83 and 101 mm Hg, respec tively (P < .001). Despite having mean arterial pressure 12 mm Hg lower tha n patients with combined hypertension, the group with isolated systolic hyp ertension had equally severe abnormalities of left ventricular mass, left v entricular geometric patterns, and measures of systolic and diastolic funct ion. Peripheral resistance was lower and pulse pressure/stroke volume ratio (arterial stiffness index) was higher and the isovolumic relaxation time s horter in isolated systolic hypertension. Multiple regression analyses iden tified age, height, BMI, stress-corrected mid wall shortening, stroke volum e, male gender, and systolic or mean blood pressure (but not isolated systo lic hypertension) as independent correlates of left ventricular mass. Relat ive wall thickness was independently associated with isolated systolic hype rtension (P = .001) in addition to mean pressure and other covariates. The present results add support to the concept that systolic blood pressure (SB P) is a stronger determinant than diastolic pressure of cardiac target orga n damage in hypertension. (C) 2001 American Journal of Hypertension, Ltd.