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Hypertension
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my personal edition > hypertension > news
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DGDispatch
Isolated Systolic Hypertension Carries Significant Structural and Functional Alterations: Presented at ASH(HYP)
By Maggie Schwarz
NEW YORK, NY -- May 21, 2003 -- Alterations in arterial structure and function identified in patients with isolated systolic hypertension may be responsible for their higher morbidity and mortality, compared to patients with systolic and diastolic hypertension.
Samer S. Najjar, MD, and colleagues from the National Institute on Aging, Baltimore, MD, studied factors underlying the increased risk of isolated systolic hypertension, and presented results here at the 18th Annual Scientific Meeting of the American Society of Hypertension.
The investigators looked at parameters of cavity size, heart wall thickness, heart function, large artery diameter, vascular stiffness, and vascular function in 302 normotensive individuals over 50 years of age, and 145 patients with untreated isolated systolic hypertension in the same age group. Participants underwent extensive cardiovascular evaluation including echocardiography, carotid ultrasonography, tonometry, and Doppler testing.
Cavity size, measured by left ventricle end-diastolic diameter, was the same for both normotensive subjects and those with isolated systolic hypertension. Heart wall thickness was significantly greater in subjects with isolated systolic hypertension, as measured by interventricular septal wall thickness, posterior wall thickness, relative wall thickness, and left ventricular wall mass. Heart function, as measured by stroke volume and cardiac output, was the same for both groups. Carotid artery diameter and carotid artery intima media were both increased in subjects with isolated systolic hypertension (P<.05).
Vascular stiffness, as measured by pulse wave velocity and central arterial compliance, was greater in the isolated systolic hypertension group (P<.05). Vascular function, as measured by peripheral vascular resistance, was higher in those with isolated systolic hypertension (P<.05). Wall shear stress was lower in individuals with isolated systolic hypertension (P<.05).
Dr. Najjar concluded that perhaps isolated systolic hypertension should be targeted separately from systolic and diastolic hypertension. "The next step will be to evaluate responses in functional and structural parameters to different classes of antihypertensive medication," he said.
[Study title: A Risky Partnership: Cardiovascular Alterations in Isolated Systolic Hypertension. Abstract-295]
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