BACKGROUND:: Hypertension is associated with cardiovascular stiffening and left ventricular diastolic dysfunction, leading to comorbidities such as heart failure with preserved ejection fraction (HFpEF). It is unknown whether sex and hypertension subtype affect haemodynamics and left ventricular function in older individuals. METHODS:: Ninety-five older patients with Stage 1 hypertension (ambulatory awake SBP135-159â€ŠmmHg) and 56 normotensive controls were enrolled. Patients were stratified prospectively into isolated systolic hypertension (ISH, DBP <85â€ŠmmHg) or systolic-diastolic hypertension (SDH, DBP ≥85â€ŠmmHg). Haemodynamics and Doppler variables including early filling (E) and averaged mitral annular (E′mean) velocities were measured during supine rest. RESULTS:: Ambulatory awake blood pressures (BPs) were the highest in SDH, whereas supine SBP was similar in both hypertensive groups. No sex difference was observed in supine or ambulatory awake BPs in all groups. Stroke volume was similar among groups within the same sex, but smaller in women. Women exhibited faster E, slower E′mean and greater E/E′mean, whereas no group difference was observed in E within the same sex. In women, E′mean was significantly slower in SDH (5. 9â€Š±â€Š1.6 vs. 7. 4â€Š±â€Š1.1â€Šcm/s, Pâ€Š<â€Š0.01) and ISH (6.6â€Š±â€Š1.6â€Š cm/s, Pâ€Š=â€Š0.07) than controls, resulting in the highest E/E′mean in SDH. In men, E′mean and E/E′mean were similar among the three groups. CONCLUSION:: These results suggest that elderly hypertensive women may have left ventricular early diastolic dysfunction and higher estimated filling pressure, consistent with their susceptibility to HFpEF. Women with SDH seemed to have more left ventricular diastolic dysfunction, which might be explained by the greater cumulative afterload when ambulatory.
- left ventricular diastolic function
- sex difference
- stage 1 hypertension
ASJC Scopus subject areas
- Internal Medicine
- Cardiology and Cardiovascular Medicine