Aterial Stiffness and Abdominal Obesity are Associated with the Relaxation Abnormality of Left Ventricle in Human Hypertension

ABSTRACT

BACKGROUND AND OBJECTIVES: Aging is a major factor related to a relaxation abnormality of the left ventricle. Increased arterial stiffness and central distribution of body fat are common physiologic changes observed in the elderly. To further elucidate the relationship between aging and a relaxation abnormality of the left ventricle, we investigate the relationship between the pulse wave velocity, abdominal obesity and diastolic function parameters of the left ventricle. SUBJECTS AND METHODS: In 490 subjects (153 normotensive, 128 prehypertensive, 120 untreated hypertensive and 89 hypertensive on anti-hypertensive drugs, aged 59.8+/-12.6 (21-88) years), the brachial-ankle pulse wave velocity (baPWV) and echocardiographic indices for a relaxation abnormality, i.e. transmitral E, A, E/A, DT, IVRT, were measured. A relaxation abnormality was defined by an E/A 240 ms in the young (240 ms in the old ( or =90 cm in male, > or =80 cm in female, OR 2.34), a high baPWV (> or =1,600 cm/sec, OR 3.96) and a high BMI (> or =25 kg/m2, OR 0.60) to be independent deter-minants of a relaxation abnormality. The age adjusted mean baPWV (1526.9+/-119.4 vs. 1577.1+/-106.9 cm/sec, p< 0.0001) and AC (86.2+/-9.8 vs. 88.5+/-7.7 cm, p=0.005) were higher in group II than group I. CONCLUSION: Arterial stiffness is the major determinant of a relaxation abnormality of the left ventricle. Abdominal obesity and a high BMI were found to be independent of each other, and an inverse relationship was found with respect to a relaxation abnormality of the left ventricle in a rural Korean population, including hypertensive patients.