Relation of age to left ventricular function and systemic hemodynamics in uncomplicated mild hypertension

Previous studies in normotensive subjects have shown a slight decline in re sting left ventricular pump function and midwall contractility with aging. We examined the relations of age to these variables and to peripheral resis tance and vascular stiffness in 272 asymptomatic, unmedicated adults (25 to 80 years old) who had uncomplicated essential hypertension. Cardiac and ca rotid ultrasound and carotid pressure waveforms were obtained to measure le ft ventricular dimensions, endocardial and midwall left ventricular shorten ing, stroke index and cardiac index, end-systolic stress, and pulse pressur e/stroke index and beta, pressure-dependent and independent measures of vas cular stiffness, respectively. Endocardial and midwall stress-corrected :le ft ventricular shortening assessed ventricular performance. Cardiac index a nd TPRI did not change with age in either gender, with age-related increase s in systolic pressure offset by increasingly concentric ventricular geomet ry in women and enhanced ventricular systolic function in men. In contrast to the lack of age-related change in traditional hemodynamic indexes, pulse pressure/stroke volume and beta strongly increased with age (P <0.001). Th us, in uncomplicated, relatively mild essential hypertension, neither cardi ac index nor peripheral resistance is associated with age. This hemodynamic stability is associated with age-related increased: concentricity of ventr icular geometry in women and increased ventricular performance indexes in h ypertensive men. Vascular stiffness progressively increases with age, indep endent of change in mean pressure or resistance, possibly contributing to i ncreased rates of cardiovascular events in older individuals.