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Echocardiographic evaluation of left and right ventricular function in mild hypertension

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Abstract

Thirty-one cases of untreated `mild hypertension' and equal number of age and sex matched controls with `normal' blood pressure were evaluated by echocardiography. Patients with mild hypertension had significantly increased left ventricular mass index, concentric remodeling, and diastolic dysfunction. Thickness of right ventricular anterior wall, flow velocities across tricuspid and pulmonary valves were also significantly higher in hypertensives. Pulmonary flow acceleration time was significantly less in hypertensives. On multiple regression analysis, mitral valve `A' wave velocity alone correlated with systolic blood pressure. Other echocardiographic variables did not have any relation with blood pressure readings. Height, weight, body surface area and body mass index could also explain only around 50% of variability in echocardiographic parameters. Cardiac structure and functions in hypertensives are affected by factors other than blood pressure reading, body surface area or body mass index. Routine echocardiography can be useful in identifying those patients of mild hypertension who have disproportionate increase in left ventricular mass or disproportionate impairment of diastolic functions.

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References

  1. Chalmers J, et al. WHO-ISH Hypertension Guidelines Sub-Committee 1999, World-Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151-185.

    Google Scholar 

  2. Abergel E, Chatellier G, Battaglia C, Menard J. Can echocardiography identify mildly hypertensive patients at high risk, left untreated based on current guidelines? J Hypertens 1999; 17: 817-824.

    Google Scholar 

  3. de Simon G. Guidelines for arterial hypertension: the echocardiography controversy. J Hypertens 1999; 17: 735-736.

    Google Scholar 

  4. Bryg RJ, Williams GA, Labovitz AJ. Effect of aging on left ventricular diastolic filling in normal subjects. Am J Cardiol 1987; 59: 971-974.

    Google Scholar 

  5. Alexander JK. The heart and obesity. In: Schlant RC and Alexander RW, editors. The Heart. New York: McGraw Hill, 1994; 1937-1942.

    Google Scholar 

  6. Inoue T, Fujito T, Asahi S, et al. Impaired left ventricular diastolic filling occurs in diabetic patients without atherosclerotic coronary artery disease. Am J Med Sci 1997; 313: 125-130.

    Google Scholar 

  7. Vriz O, Piccolo D, Cozzutti E, et al. The effects of alcohol consumption on ambulatory blood pressure and target organs in subjects with borderline to mild hypertension. HARVEST Study Group. Am J Hypertens 1998; 11: 230-234.

    Google Scholar 

  8. Shapiro LM, Smith RG. Effect of training on left ventricular structure and function: An echocardiographic study. Br Heart J 1983; 50: 534-539.

    Google Scholar 

  9. Gottdiener JS, Reda DJ, Massie BM, Materson BJ, Williams DW, Anderson RJ. Effect of single drug therapy on reduction of left ventricular mass in mild to moderate hypertension: comparison of six antihypertensive agents. Circulation 1997; 95: 2007-2014.

    Google Scholar 

  10. Tripathi KD. Pharmacodynamics. In: Tripathi KD, editor. Essentials of medical pharmacology. New Delhi: Jaypee Brothers, 1994; 34-64.

    Google Scholar 

  11. Park K, Obesity. In: Park K, editor. Preventive and social medicine. Jabalpur: Banarsidas Bhanot publisher, 1994; 272-274.

    Google Scholar 

  12. Sahan DJ, De Maria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-1083.

    Google Scholar 

  13. Matsukubi H, Matsuura T, Endo N, et al. Echocardiographic measurement of right ventricular wall thickness: A new approach of subxiphoid echocardiography. Circulation 1977; 56: 278-284.

    Google Scholar 

  14. Palatini P, Visentin P, Mormino P, et al. Structural abnormalities and not diastolic dysfunction are the earliest left ventricular changes in hypertension. Am J Hypertens 1998; 11: 147-154.

    Google Scholar 

  15. Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelle WP. Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J cardiol 1987; 59: 956-959.

    Google Scholar 

  16. Dreslinski GR. Identification of left ventricular hypertrophy: Chest roentgenography, echocardiography and electrocardiography. Am J Med 1983; (suppl 3A): 47-50.

    Google Scholar 

  17. Mahajan BK. Significance of difference between means of small samples by Student's t-test. In: Mahajan BK, editor. Methods in biostatistics for medical students and research workers. New Delhi: Jaypee Brothers, 1999; 141-143.

    Google Scholar 

  18. Donald HS. Multiple linear regression and correlation. In: Donald MS, editor. Statistics: A fresh approach. New York: Mc Graw Hill, 1990; 568-575.

    Google Scholar 

  19. Culpepper WS. Cardiac anatomy and function in juvenile hypertension: current understanding and future concerns. Am J Cardiol 1983; 75(suppl IIIA): 57-61.

    Google Scholar 

  20. Armario P, del Rey RH, Sanchez P, et al. Determinants of left ventricular mass in untreated mildly hypertensive subjects: hospitalet study in mild hypertension. Hypertens 1999; 12: 1084-1090.

    Google Scholar 

  21. Devereux RB, Lutas EM, Casale PN, et al. Standardization of m-mode echocardiographic left ventricular anatomic measurements. J Am Coll Cardiol 1984; 4: 1222-1230.

    Google Scholar 

  22. Culpepper WS, Sodt PC, Messerli FH, Ruschhaupt DG, Arcilla RA. Cardiac status in juvenile borderline hypertension. Ann Intern Med 1983; 98: 1-7.

    Google Scholar 

  23. Harrap SB, Dominiczak AF, Fraser R, et al. Plasma angiotensin II predisposes to hypertension and left ventricular size in healthy young adults. Circulation 1996; 93: 1148-1154.

    Google Scholar 

  24. Lind L, Anderson PE, Andren B, Hanni A, Lithell HO. Left ventricular hypertrophy in hypertension is associated with the insulin resistance metabolic syndrome. J Hypertens 1995; 13: 433-438.

    Google Scholar 

  25. Verdecchia P, Schillachi G, Borgioni C, et al. Prognostic value of left ventricular mass and geometry in systemic hypertension with left ventricular hypertrophy. Am J Cardiol 1996; 78: 197-202.

    Google Scholar 

  26. Frohlich ED. Pathophysiology of systemic arterial hypertension. In: Schlant RC, Alexander RW, editors. The Heart. New York: McGraw Hill, 1994; 1391-1401.

    Google Scholar 

  27. Mc Cubbin JW, Green JH, Page IH. Baroreceptor functions in chronic renal hypertension. Cir Res 1956; 4: 205-210.

    Google Scholar 

  28. Yamori Y, Mori C, Nishio T, et al. Cardiac hypertrophy in early hypertension. Am J Cardiol 1979; 44: 964-969.

    Google Scholar 

  29. Palatini P, Visentin P, Mormino P, et al. Left ventricular performance in the early stages of systemic hypertension. Am J Cardiol 1998; 81: 418-423.

    Google Scholar 

  30. Pearlman AS. Technique of doppler and colour flow doppler in the evaluation of cardiac disorders and function. In: Schlant RC, Alexander RW, editors. The Heart. New York: Mc Graw Hill, 1994; 2229-2251.

    Google Scholar 

  31. Verdecchia P, Schillaci G, Guerrieri M, et al. Prevalence and determinants of diastolic filling abnormalities in an unselected hypertensive population. Eur Heart J 1990; 11: 679-691.

    Google Scholar 

  32. Liebson PR, Grandits G, Prineas R, et al. Echocardiographic correlates of left ventricular structure among 844 mildly hypertensive men and women in the treatment of mild hypertension study (TOMHS). Circulation 1993; 87: 476-486.

    Google Scholar 

  33. Phillips RA, Coplan NL, Krakoff LR, et al. Doppler echocardiographic analysis of left ventricular filling in treated hypertensive patients. J Am Coll Cardiol 1987; 9: 317-322.

    Google Scholar 

  34. Inouye I, Massie B, Loge D, et al. Abnormal left ventricular filling: an early finding in mild to moderate hypertension. Am J Cardiol 1984; 53: 120-126.

    Google Scholar 

  35. Mittal SR, Arora SK, Mantri VP, Pamecha S. Echocardiographic evaluation of left ventricular functions in persons with diastolic blood pressure between 90 and 100 mmHg. J Appl cardiol 1990; 5: 383-388.

    Google Scholar 

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Mittal, S., Barar, R. & Arora, H. Echocardiographic evaluation of left and right ventricular function in mild hypertension. Int J Cardiovasc Imaging 17, 263–270 (2001). https://doi.org/10.1023/A:1011660827368

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