[Is arterial hypertension in women different from that in men? Example of the relationship between arterial pressure and left ventricular mass]. / L'HTA de la femme est-elle différente de celle de l'homme? Exemple de la relation pression artérielle-masse ventriculaire gauche.

In the Bordeaux cohort of never treated, uncomplicated hypertensive patients with office BP > 140/90 on at least 2 occasions, we selected those with good quality 24 H ambulatory BP measurement and LVM measured with M mode echo before any antihypertensive treatment. In this group, we studied the relationships between LVM and average 24 h systolic BP in males and females in univariate and multivariate analysis, taking into account age, weight and height. The population studied included 531 patients whose main characteristics are summarized in the table. The slope of the relationship between LVM and 24 h SBP is significantly steeper in males than in females (1.73 vs 0.58, p < 0.01). In multivariate analysis, the variable showing the higher correlation to LVM is 24 h SBP in males, weight in females. For a similar increase in BP, males hypertensive show a higher increase in LVM than females.

[Assessment of arterial distensibility by ambulatory monitoring of QKD interval. Reproducibility of the method]. / Appréciation de la rigidité artérielle par monitoring ambulatoire de l'intervalle QKD. Reproductibilité de la méthode.

We have proposed the use of the ambulatory monitoring of the timing of Korotkoff sounds (QKD interval) to assess arterial distensibility. This interval is inversely linked to pulse wave velocity. The study of its variations according to spontaneous blood pressure changes during 24 h allows to calculate indices of arterial distensibility independent of actual blood pressure. A normalized QKD100-60 is calculated as the value for a 60 batt/min heart rate and a 100 mmHg systolic blood pressure from the individual multivariate linear relationship between these 3 variables. This interval decrease with arterial distensibility. We tested the reproducibility of this method in 28 normal subjects (14 males, 14 females, aged 43 +/- 16 years) who underwent two 24 h recordings during daily routine separated by one week. Standard deviation of differences for QKD100-60 was 12 ms, the coefficient of variation 6% and the coefficient of repeatibility 24 ms. So QKD100-60 shows a good reproducibility in the same range that 24 h blood pressure means.

Assessment of arterial distensibility by monitoring the timing of Korotkoff sounds.

The timing of Korotkoff sounds, blood pressure, and heart rate can now be monitored in the ambulatory patient: the QKD interval is the time between the onset of the depolarization on the electrocardiogram (Q) and detection of the last Korotkoff sound (K) at the level of brachial artery during cuff deflation, corresponding to diastolic blood pressure (D). Because this interval is inversely related to pulse wave velocity, this recently developed device enables evaluation of the influence of blood pressure on arterial rigidity, providing valuable information on the properties of the arteries. In this study, we examined the influence of hypertension and age on the above parameters and their correlations to left ventricular mass. QKD interval, blood pressure, and heart rate were monitored over a period of 24 h (four measurements/hour) in 33 normotensive and 70 untreated essential hypertensive patients. The slopes of the plots of QKD interval versus systolic and pulse pressure during the 24 h were calculated for each patient. The influence of age and hypertension on these slopes was tested by comparison of matched groups and multivariate analysis. Moreover the relationships between these parameters and echocardiographically assessed left ventricular mass were studied in 37 patients. We found a reduction in mean QKD interval with age and hypertension, reflecting the recognized higher pulse wave velocity in these patients. The slopes of the plots of QKD interval versus blood pressure were also lower in these patients, indicating the smaller influence of a change in blood pressure on pulse wave velocity in patients with stiffer arteries.(ABSTRACT TRUNCATED AT 250 WORDS)