González Quijada S, Luque Otero M, Fernández-Cruz A, Almería C, Bagazgoitia Barrera J, Moya Marín F J
Unidad de Hipertensión, Hospital Universitario San Carlos, Madrid.
Med Clin (Barc). 1997 Oct 11;109(12):441-4.
The prevalence of left ventricular hypertrophy (LVH) is higher in elderly patients with hypertension than in normotensive patients. The factors relationed herewith are not well known. The first purpose was to analyse the relationship between the levels of blood pressure (BP) recorded by ambulatory blood pressure monitoring (ABPM) and the left ventricular mass index (LVMI) in a group of untreated patients older than 55 years with essential hypertension. Our second purpose was to observe the relationship between the concentration of several circulating hormones and the left ventricular mass index.
The study included 31 untreated patients with mild to moderate essential hypertension and 37 healthy normotensives. Both groups were of similar age, sex and body mass index. We determined for both groups the casual arterial pressure (CAP), ambulatory BP monitoring (ABPM) throughout 24 h, daytime (07.00-23.00 h), nighttime (23.00-07.00 h), left ventricular mass index (LVMI) (following Devereux's formula) and circulating levels of endothelin-1, aldosterone, renine, free adrenaline and noradrenaline.
The ILVM in hypertensive patients was 139.6 +/- 35.9 g/m2 and in 124.0 +/- 31.8 g/m2 in normotensive (p < 0.05). The percentage of patients with LVH was 63 and 43%, respectively (p < 0.05). The LVMI in hypertensive patients was correlated with the diastolic CAP (97 +/- 7 mmHg) (r = 0.41; p < 0.05), unlike with the systolic CAP (164 +/- 18 mmHg). The ILVM in normotense patients was not associated neither with the systolic CAP (126 +/- 10 mmHg) nor with the diastolic (79 +/- 6 mmHg). In hypertensive patients we found a slight association between the LVMI and the systolic ABPM (130 +/- 14 mmHg) during nighttime (r = 0.41; p < 0.05). The rest of average ambulatory BP and the hormonal values at study did not show a correlation with the LVMI in both groups.
A slight correlation exists between BP (casual and determined with ambulatory blood pressure monitoring throughout 24 hours) and the left ventricular mass index in mild to moderate untrated hypertensive patients older than 55 years. We did not observe correlations between the circulating levels of endothelin-1, renin, aldosterone, free adrenaline and noradrenaline and the left ventricular mass. The average ventricular mass and the number of subjects with ventricular hypertrophy was significantly increased in hypertensives than in normotensives.
老年高血压患者左心室肥厚（LVH）的患病率高于血压正常者。与之相关的因素尚不清楚。第一个目的是分析动态血压监测（ABPM）记录的血压（BP）水平与一组年龄大于55岁的未经治疗的原发性高血压患者的左心室质量指数（LVMI）之间的关系。我们的第二个目的是观察几种循环激素的浓度与左心室质量指数之间的关系。
该研究纳入了31例未经治疗的轻度至中度原发性高血压患者和37例健康血压正常者。两组在年龄、性别和体重指数方面相似。我们测定了两组的偶测动脉压（CAP）、24小时动态血压监测（ABPM）、日间（07:00 - 23:00）、夜间（23:00 - 07:00）、左心室质量指数（LVMI）（根据Devereux公式）以及内皮素 - 1、醛固酮、肾素、游离肾上腺素和去甲肾上腺素的循环水平。
高血压患者的LVMI为139.6±35.9 g/m²，血压正常者为124.0±31.8 g/m²（p < 0.05）。LVH患者的百分比分别为63%和43%（p < 0.05）。高血压患者的LVMI与舒张压CAP（97±7 mmHg）相关（r = 0.41；p < 0.05），与收缩压CAP（164±18 mmHg）无关。血压正常者的LVMI与收缩压CAP（126±10 mmHg）和舒张压（79±6 mmHg）均无关。在高血压患者中，我们发现夜间LVMI与收缩期ABPM（130±14 mmHg）之间存在轻微关联（r = 0.41；p < 0.05）。研究中其余的平均动态血压和激素值在两组中均未显示与LVMI相关。
在年龄大于55岁的轻度至中度未经治疗的高血压患者中，血压（偶测和24小时动态血压监测测定）与左心室质量指数之间存在轻微相关性。我们未观察到内皮素 - 1、肾素、醛固酮、游离肾上腺素和去甲肾上腺素的循环水平与左心室质量之间的相关性。高血压患者的平均心室质量和心室肥厚患者数量显著高于血压正常者。
