Abstract 17402: Young Women Have More Impaired Left Ventricular Diastolic Function than Young Men in Patients with Never Treated Primary Arterial Hypertension
Introduction & Purposes: Although the prevalence of arterial hypertension (HT) is higher in men than women in young adults, the gender difference of the anatomic and functional cardiac remodeling by high blood pressure (BP) and its relationship to renin-angiotensin aldosterone system has not been well evaluated. We aimed to evaluate the gender difference of the cardiac remodeling and its relationship to serum aldosterone in young patients with never treated HT.
Methods: Consecutive young patients with first diagnosed and never-treated primary HT were enrolled. Patients with diabetes mellitus, structural heart diseases and Cr>1.5mg/dL were excluded. Conventional 2D echocardiography was performed and left ventricular (LV) strain values were obtained by speckle tracking imaging analysis. Serum aldosterone concentration (SAC) and plasma renin activity (PRA) were obtained.
Results: Seventy-five patients (31.1±6.2 years) were enrolled and 15 patients (20%) were women. The average systolic and diastolic BP were 155.5±13.2 and 98.5±11.3mmHg, respectively. LV mass index (LVMI) and LV ejection fraction were similar in both groups (p=0.22 and p=0.77, respectively). However, women had higher LV relative wall thickness (RWT, 0.37±0.08 vs. 0.42±0.09, p=0.03) and lower global longitudinal and circumferential strain (p=0.04 and p=0.03, respectively). The e’ velocity of mitral annulus was significantly lower (7.4±1.5 vs. 9.8±2.6cm/s, p=0.001) and E/e’ was significantly higher (10.7±2.6 vs. 7.0±2.0, p<0.001) in women than in men. Even with adjusted by age, both e’ velocity and E/e’ were significantly different by gender (p=0.015 and p<0.001, respectively). SAC (p=0.03) but not PRA were higher in women than in men. SAC was related with LVMI (r=0.373, p=0.004), RWT (r=0.368, p=0.005), e’ velocity (r=-0.413, p=0.001), E/e’ (r=0.455, p=0.001), LV global longitudinal and circumferential strain (r=-0.288, p=0.03 and r=0.315, p=0.01).
Conclusion: Women HT patients had worse LV diastolic function and LV strain values than men HT patients even they were young, which were related to higher SAC in women. Our findings may suggest that women are more prone to develop LV diastolic dysfunction and heart failure by high BP than men even they are young adults.
Author Disclosures: S. Park: None. S. Kim: None. M. Kim: None. W. Shim: None.
- © 2014 by American Heart Association, Inc.