Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Gender differences in the relationship between left ventricular size and ambulatory blood pressure in borderline hypertension
The HARVEST Study
Padua, Italy
revised 22 October 1996; accepted 23 October 1996.
Correspondence: Prof. Paolo Palatini, Trial Coordinator, Clinica Medica 1, Via Giustiniani, 2, 35126 Padova, Italy
Abstract
AIM: To assess whether there are gender differences in cardiac adaptation to raised blood pressure levels in young subjects with borderline to mild hypertension.
METHODS AND RESULTS: In 499 18–45-year-old stage I hypertensive subjects (377 men and 122 women) with a mean age of 33±9 years and office blood pressure of 146±11/94±6 mmHg, ambulatory blood pressure monitoring in duplicate, echocardiography and 24-h urinary catecholamines measurement were performed.
RESULTS: The whole group was divided into quartiles of increasing daytime blood pressure and differences in left ventricular echocardiographic data were analysed in the two sexes separately. In men no left ventricular parameter differed across the quartiles, while in women left ventricular mass, posterior wall thickness and interventricular septum thickness showed a clear tendency to increase with increasing levels of systolic blood pressure. In multiple regression analysis, daytime systolic blood pressure explained only a small fraction of the variance in left ventricular parameters in men, while in women daytime systolic blood pressure was a main determinant of left ventricular mass and posterior wall and septal thicknesses. Body weight explained most of the variance in all dimensional parameters in men. In women weight was an important predictor of left ventricular mass and diameter, but was unrelated to left ventricular posterior wall and septal thicknesses.
CONCLUSIONS: Daytime systolic blood pressure is the most important predictor of left ventricular mass and geometry in pre-menopausal women with stage I hypertension, while in men left ventricular dimensional indeces are chiefly explained by body weight.
Key Words: Gender • borderline hypertension • left ventricular hypertrophy • ambulatory monitoring • echocardiography
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