Abstract:

Objective To investigate the effects of age and hypertension on cardiac structure and function in senile patients with essential hypertension. Methods One hundred and fifty hospitalized patients with essential hypertension were divided into senile hypertension group (n=84), senile non-hypertension group (n=18) and elderly hypertension group (n=48) according to age (senile, ≥80 years old; elderly, 60 to 80 years old) and conditions of hypertension. The baseline conditions were recorded, the blood biochemical parameters were measured, and 24 h ambulatory blood pressure monitoring was performed. Cardiac ultrasonography was conducted, and parameters of cardiac structure and function were measured and calculated. The correlation of disease course of hypertension with cardiac structure and function was analysed. Results There were significant differences in mean age, body mass index, total cholesterol, high-density lipoprotein and low-density lipoprotein between senile hypertension group and elderly hypertension group (P<0.05 or P<0.01). The 24 h systolic blood pressure and diastolic blood pressure in senile hypertension group were significantly higher than those in senile non-hypertension group (P<0.01), and there were significant differences in left ventricular mass, left ventricular mass index and left ventricular posterior wall thickness between these two groups (P<0.01), while there was no significant difference in parameters of cardiac structure between senile hypertension group and elderly hypertension group (P>0.05). The parameters of cardiac function in senile hypertension group were significantly different from those in elderly hypertension group and senile non-hypertension group (P<0.05). Correlation analysis revealed that the disease course of hypertension was positively related to the parameters of cardiac structure (P<0.05 or P<0.01), while was negatively related to the parameters of cardiac function (P<0.05). Conclusion In senile patients, hypertension may cause more serious left ventricular hypertrophy, increased cardiac mass and decreased cardiac systolic function. With the prolongation of disease course of hypertension, more severe left ventricular hypertrophy and left atrial and ventricular enlargement occur, and even serious left ventricular systolic function takes place. Decreasing blood pressure stably in a rational range is advisable for senile patients with essential hypertension.

Key words: hypertension, aging, left ventricular mass index, left ventricular hypertrophy, left ventricular ejection fraction