Systolic rather than diastolic pressure mainly responsible for LV hypertrophy

מתוך medicontext.co.il

By Steven Reinberg

WESTPORT, CT (Reuters Health) – Isolated systolic hypertension (ISH) has a similar effect on left ventricular structure and function as combined systolic and diastolic hypertension (CSDH), according to a report in the August issue of the American Journal of Hypertension.

Dr. Vasilios Papademetriou from the Veterans Administration Medical Center in Washington, DC and colleagues with the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) trial report on a comparison of echocardiograms from 143 patients with ISH and 808 patients with CSDH.

The researchers found that patients with ISH had as much left ventricular hypertrophy as patients with CSDH, Dr. Papademetriou told Reuters Health in an interview. "In fact, patients with ISH had worse arterial compliance and peripheral resistance, so overall these patients were worse off than patients with CSDH," he added.

Age, height, body mass index, stress-corrected mid-wall shortening, stroke volume, male gender and systolic or mean blood pressure, but not ISH, were identified as independent correlates of left ventricular mass by multiple regression analysis, Dr. Papademetriou's group notes.

The findings "add support to the concept that systolic blood pressure is a stronger determinant than diastolic pressure of cardiac target organ damage in hypertension," the authors conclude. In other words, systolic hypertension should not be viewed as a benign condition but as a worse condition than combined systolic and diastolic hypertension, Dr. Papademetriou said.

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