Arterial plasma noradrenaline predicts left ventricular mass independently of blood pressure and body build in men who develop hypertension over 20 years

被引:39
作者
Strand, Arne H.
Gudmundsdottir, Helga
Os, Ingrid
Smith, Gunnar
Westheim, Arne S.
Bjornerheim, Reldar
Kjeldsen, Sverre E.
机构
[1] Ullevaal Univ Hosp, Dept Cardiol, N-0407 Oslo, Norway
[2] Ullevaal Univ Hosp, Dept Nephrol, N-0407 Oslo, Norway
[3] Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA
关键词
diastolic dysfunction; hypertension; left ventricular hypertrophy; sympathetic nervous system;
D O I
10.1097/01.hjh.0000222761.07477.7b
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background Increased sympathetic activity may be an underlying mechanism in cardiovascular disease. It has been hypothesized that the degree of left ventricular (LV) hypertrophy is partly related to the blood pressure level, and partly to neurohormonal factors. The aim of this study was to investigate predictors of LV mass, including arterial plasma noradrenaline as an index of sympathetic activity, with particular emphasis on subjects who developed hypertension over a period of 20 years. Methods In a 20-year prospective study of middle-aged men, sustained hypertensives (n = 22), new hypertensives (crossovers) (n = 17) and sustained normotensives (controls) (n = 17) were examined both at baseline and after 20 years of follow-up (at ages 42.1 +/- 0.5 and 62.3 +/- 0.6 years, respectively). Relationships between arterial plasma catecholamines, blood pressure and body mass index at baseline to left ventricular parameters by echocardiography at follow-up were investigated. Results Groups were homogeneous regarding age, gender, race and body build. The group of sustained hypertensives had significantly more LV hypertrophy (P = 0.025) and diastolic dysfunction (P = 0.010). Among the crossovers, LV mass index was positively correlated to arterial plasma noradrenaline (r = 0.50, P = 0.043) and body mass index (BMI) (r = 0.51, P = 0.039) and showed a positive trend with systolic blood pressure (SBP) at baseline. Arterial plasma noradrenaline (beta = 0.47) was found to predict LV mass index after 20 years independently of BMI (P = 0.45) and SBP (beta = 0.22) at baseline (R-2 adjusted = 0.345, P = 0.037). Such a relationship was not found in the controls or in the sustained hypertensives, of which 16 were treated with anti hypertensive drugs. Conclusions Arterial plasma noradrenaline at baseline, as an index of sympathetic activity, predicts LV mass at follow-up independently of systolic blood pressure and body build in middle-aged men who developed hypertension over a period of 20 years.
引用
收藏
页码:905 / 913
页数:9
相关论文
共 42 条
[1]   Doppler evaluation of left and right ventricular diastolic function: A technical guide for obtaining optimal flow velocity recordings [J].
Appleton, CP ;
Jensen, JL ;
Hatle, LK ;
Oh, JK .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 1997, 10 (03) :271-292
[2]   Norepinephrine-induced changes in cardiac transforming growth factor-β isoform expression pattern of female and male rats [J].
Briest, W ;
Homagk, L ;
Rassler, B ;
Ziegelhöffer-Mihalovicová, B ;
Meier, H ;
Tannapfel, A ;
Leiblein, S ;
Saalbach, A ;
Deten, A ;
Zimmer, HG .
HYPERTENSION, 2004, 44 (04) :410-418
[3]   Cardiac remodeling after long term norepinephrine treatment in rats [J].
Briest, W ;
Hölzl, A ;
Rassler, B ;
Deten, A ;
Leicht, M ;
Baba, HA ;
Zimmer, HG .
CARDIOVASCULAR RESEARCH, 2001, 52 (02) :265-273
[4]   VALUE OF ECHOCARDIOGRAPHIC MEASUREMENT OF LEFT-VENTRICULAR MASS IN PREDICTING CARDIOVASCULAR MORBID EVENTS IN HYPERTENSIVE MEN [J].
CASALE, PN ;
DEVEREUX, RB ;
MILNER, M ;
ZULLO, G ;
HARSHFIELD, GA ;
PICKERING, TG ;
LARAGH, JH .
ANNALS OF INTERNAL MEDICINE, 1986, 105 (02) :173-178
[5]   ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR HYPERTROPHY - COMPARISON TO NECROPSY FINDINGS [J].
DEVEREUX, RB ;
ALONSO, DR ;
LUTAS, EM ;
GOTTLIEB, GJ ;
CAMPO, E ;
SACHS, I ;
REICHEK, N .
AMERICAN JOURNAL OF CARDIOLOGY, 1986, 57 (06) :450-458
[6]   Hypertension, hypertrophy, hormones, and the heart [J].
Glasser, SP .
AMERICAN HEART JOURNAL, 1998, 135 (02) :S16-S20
[7]   PLASMA-CATECHOLAMINES AND ESSENTIAL-HYPERTENSION - AN ANALYTICAL REVIEW [J].
GOLDSTEIN, DS .
HYPERTENSION, 1983, 5 (01) :86-99
[8]   Adrenergic and reflex abnormalities in obesity-related hypertension [J].
Grassi, G ;
Seravalle, G ;
Dell'Oro, R ;
Turri, C ;
Bolla, GB ;
Mancia, G .
HYPERTENSION, 2000, 36 (04) :538-542
[9]   Hypertensive left ventricular hypertrophy: Relation to peripheral sympathetic drive [J].
Greenwood, JP ;
Scott, EM ;
Stoker, JB ;
Mary, DASG .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 38 (06) :1711-1717
[10]   Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death [J].
Haider, AW ;
Larson, MG ;
Benjamin, EJ ;
Levy, D .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 32 (05) :1454-1459