Relationship of age, left ventricular hypertrophy and ambulatory pulse pressure in patients with essential hypertension

To investigate the relationship between age, left ventricular hypertrophy and ambulatory pulse pressure (PP). 337 initially untreated subjects with mild to moderate essential hypertension (age 51.9±8.8; 43.6% men) were involved in this study. All subjects underwent 24 h ambulatory blood pressure monitoring and echocardiography. They were divided into four groups according to their ambulatory pulse pressure scale, group A: 24 h PP<40mmHg; group B: 40mmHg≤24 h PP<50mmHg; group C: 50mmHg≤24 h PP<60mmHg; group D: 24 h PP≥60mmHg. Patients were divided into left ventricular hypertrophy(LVH) and non-LVH group according to their left ventricular mass index (LVMI) level. Patients were further divided into three age groups, group I: 40≤age<50; group II: 50≤age<60; group III: age≥60, respectively. Ambulatory pulse pressure were significantly correlated with age (r=0.423, p<0.01), arterial stiffness index (r=0.670, p<0.01), LVMI (r=0.277, p<0.01), and 24 h heart rate (r=–0.168, p<0.01). Hypertensive subjects showed a progressive increase in 24 h PP earlier, and the rate of rise accelerated after age 60 years. Both 24 h PP and 24 h SBP were significantly higher in LVH group than non-LVH group (49.0±10.2mmHg vs 44.7±8.9mmHg, p<0.001 and 132.1±13.1mmHg vs 126.5±12.7mmHg, p<0.001). Pulse pressure rose progressively with aging, and after 60 years, the rate accelerated steeply. In middle-aged and elderly subjects, the increase in PP was primarily due to large-artery elasticity deterioration. And it was the important determinant of LVH.