Increased sympathoadrenomedullary activity and left ventricular hypertrophy in young patients with borderline hypertension

Abstract

Echocardiographic dimensions and endocrinological examination were performed in 71 young patients with borderline hypertension (BHT) and 31 age-matched normotensive subjects (NT). Patients with BHT had significantly higher relative wall thickness (RWT) and left ventricular mass index than NT, although all BHT patients showed no asymmetric increase in the ratio of septal to posterior wall thickness. Moreover, these BHT patients demonstrated an increased cardiac output and an augmented mean circumferential fiber shortening rate (mean Vcf), suggesting left ventricular hyperfunction. Overall, there was a positive correlation between RWT and mean Vcf in BHT patients (r = 0.700, P less than 0.001), although there was no significant relationship between RWT and blood pressure. Furthermore, these BHT patients had higher plasma epinephrine (PE) and plasma renin activity compared to NT, suggesting the increased sympathoadrenomedullary activity in BHT. These BHT patients were divided into two groups with regards to PE levels; namely a high PE group (PE greater than or equal to 46 pg/ml) and a normal PE group (PE less than 46 pg/ml). The high PE group had a significantly higher mean Vcf and RWT than the normal PE group. These findings suggest that in young BHT patients left ventricular hypertrophy could be related to abnormalities of the sympathoadrenomedullary systems.