LEFT-VENTRICULAR CARDIAC STRUCTURE AND DIASTOLIC FUNCTION IN ISOLATED SYSTOLIC HYPERTENSION IN THE ELDERLY

We examined the left ventricular cardiac structure and the diastolic function in patients with isolated systolic hypertension (ISH; SBP greater-than-or-equal-to 160 mmHg and DBP < 90 mmHg) in the elderly. We studied 17 patients with ISH, 24 age-matched patients with essential hypertension (EHT; DBP greater-than-or-equal-to 90 mmHg) and 17 normotensive controls (NT; SBP < 140 mmHg and DBP < 90 mmHg). EHT were divided into two groups based on the mean wall thickness (MWT) of the left ventricle. Group 1 patients (EHT-1, n = 12) had a MWT < 10 mm and group 2 patients (EHT-II, n = 12) had a MWT greater-than-or-equal-to 10 mm. We measured left ventricular end-diastolic dimension (LVDd), end-systolic dimension (LVDs), left ventricular mass index (LVMi) and left ventricular isovolumic relaxation time (IRT) to assess the left ventricular cardiac structure and the diastolic function by M-mode echocardiography. LVDd was significantly smaller in ISH than in NT, EHT-I and EHT-II (P < 0.01). Relative wall thickness was greatest in ISH because of both the decreased chamber size and the increased left ventricular wall thickness. LVMi in ISH was similar to that in EHT-I, but IRT in ISH was significantly longer than that in EHT-I (P < 0.05). These results suggest that ISH in the elderly shows a left ventricular concentric hypertrophy and a severely impaired diastolic function.