Left Ventricular Diastolic Filling in Elderly Hypertensive Patients

Abstract

Objective: To evaluate the effects of mild to moderate hypertension and of LVH on diastolic filling and other Doppler indices in the elderly. Design: Survey with a control group. Subjects: Seventy‐one hypertensives (34 men, 37 women) referred for echocardiograms and 32 age‐ and sex‐matched normotensive volunteers. Thirty‐six of the hypertensives had LVH; 34 did not. Setting: Echocardiography laboratory. Measurements: M‐mode, two‐dimensional, and pulsed Doppler echocardiograms. A wide variety of Doppler‐derived indices of diastolic function were assessed. Results: All Doppler derived indices of left ventricular diastolic filling (peak E, peak A, their ratio, EF slope, time‐velocity integrals, atrial filling fraction, and isovolumic relaxation time) were similar among the three groups. Conclusion: Elderly mild to moderate hypertensives with or without LVH have LV diastolic filling that is normal for age. The identification of pathological diastolic dysfunction requires comparison to age‐matched controls, since aging, a major factor influencing diastolic filling, can mask the effect of hypertension.