Left ventricular filling in the hypertensive patient: long-term course and influence of treatment.

Background: Hypertension is accompanied by abnormalities in left ventricular filling; however, there is a lack of agreement on the extent of the influence of antihypertensive treatment on them.

Hypothesis: The present study was designed to evaluate the long-term course of these abnormalities in both treated and untreated hypertensive patients.

Methods: Left ventricular filling assessed by pulsed Doppler echocardiography of mitral flow was studied over a long follow-up period in both untreated and treated hypertensive patients. This retrospective study included 73 hypertensive patients who had not received any treatment. They had been followed up for at least 3 years and were divided a posteriori into two groups: Group 1 comprised the untreated patients, while Group 2 included the patients who had received antihypertensive treatment throughout the follow-up period.

Results: In the overall population, age and heart rate measured during the Doppler examination were the only parameters that correlated significantly with mitral flow. No significant changes in blood pressure or left ventricular mass were observed in Group 1 (14 patients) over the study period. There was a slight but nonsignificant decrease in E/A ratio of mitral flow. In the treated patients, there was a drop in heart rate-adjusted E/A ratio, despite a reduction in blood pressure and left ventricular mass, at mean follow-up of 5 years.

Conclusion: Antihypertensive therapy did not arrest the long-term reduction in E/A ratio in hypertensive patients despite reduction in blood pressure and left ventricular mass.