Early changes of left ventricular function in young adults with never-treated hypertension and no left ventricular hypertrophy: relationships to ambulatory blood pressure monitoring.

ABSTRACT

The number of young adults with hypertension (HT) is increasing. We investigated the changes of left ventricular (LV) function and their relationship to the ambulatory blood pressure monitoring (ABPM) parameters in young adults with never-treated HT and no LV hypertrophy. Consecutive young patients (29.5 ± 5.9 years) with first diagnosed primary HT and sex- and age-matched normotensive controls were enrolled. We excluded patients who had LV hypertrophy. ABPM was performed in all HT patients. LV strain values were obtained by two-dimensional speckle tracking imaging. There was no difference in LV ejection fraction and mass index between HT patients (n = 40) and controls (n = 40). LV global longitudinal strain (GLS) was lower (p = 0.001) and twist was higher (p = 0.002) in HT patients than in controls. LV GLS was significantly correlated to averaged and daytime diastolic BP and its variability and most related to daytime diastolic BP (ß = 0.33, p = 0.03). Patients with high daytime diastolic BP and its variability showed lower GLS (both p = 0.02) and higher twist (both p = 0.04) than patients with low daytime diastolic BP. Early changes of LV function with decreased GLS and increased twist were shown in young HT patients even with no LV hypertrophy and daytime diastolic BP and its variability were related to the impairment of LV function.