Estructura y funcion del ventriculo izquierdo en jovenes estudiantes varones de la Universidad Nacional de La Plata con hipertension arterial en estadio I

From an homogeneous population of 219 male medical students of La Plata University (20.9 ± 1.6 years) who underwent a blood pressure screening, 34 were selected for measurements of left ventricular structure and function. Considering the JNC-V classification, samples from two groups were selected for comparisons: Optimal blood pressure (OBP)(21 males, 20.33 ± 1.8 years) and Hypertensives stage I (H) (13 males, 20.85 ± .66 years). The H showed values of body mass index (BMI) and heart rate (HR) higher than OBP (BMI OBP: 22.5 ± 0.38 kg/m ², H: 24.26 ± 0.84 kg/m ₂ -p < 0.04; HR OBP: 69.9 ± 1.53 lat/min-H 80.5 ± 3.58 lat/min -p < 0.03). Although the H were not reaching values of left ventricular mass index (LVMI) or septal (S) and posterior wall thickness to be considered hypertrophics, they were exceeding the OBP group (LVMI OBP: 89.6 ± 3.33 g/m ², H: 124.5 ± 6 g/m ² -p < 0.01; S OBP: 8.7 ± 0.17 mm, H: 11.5 ± 0.04 mm; P OBP: 7.9 ± 0.18 mm, H: 10 ± 0.13 mm -p < 0.01). Cardiac index (Cl) was increased in H (OBP: 3.3 ± 0.14 l/min/m ², H:4.8 ± 0.36 l/min/m ² -p < 0.01) supporting the existence of a hyperkinetic circulatory phase. OBP showed total peripheral resistance (TPR) higher than H group (OBP: 17 ± 0.8 mmHg/l.min.m ², H: 13 ± 1 mmHg/l.min.m ² -p < 0.008). Left ventricular (LV) systolic function indexes were not different in the two groups analyzed. The pattern of left ventricular late filling was however different between the two groups. The area of late diastolic flow (Area A) was lower in OBP (OBP: 2.64 ± 0.09 cm ², H: 3.78 ± 0.95 cm ² -p < 0.01) independently of HR value (adjusted mean OBP: 2,9 ± 0,09 cm ² H: 3,52 ± 0,95 cm ² -p < 0,01). The early filling fraction (EFF) was also detecting a significant shift to more prominent late diastolic filling in H (OBP 0.72 ± 0.06%, H: 0.64 ± 0,01% - p < 0,01) independently of HR values (adjusted mean PAO: 0.71 ± 0.96%, H: 0.65 ± 0.01 % -p < 0.01). Healthy young males with hypertension stage I have similar LV systolic function, increased Cl, LVMI, LV wall thickness, decreased TPR and evidence of impaired LV filling with shift of the pattern of filling to a fate flow.