Objective

To investigate the inter-relationship between aortic stiffness and left ventricular (LV) diastolic function in subjects with newly diagnosed uncomplicated essential hypertension.

Methods

We studied 106 consecutive newly diagnosed subjects (aged 51 years, 80 males) with stage I–II essential hypertension, and 50 normotensives matched for age, sex and body mass index. LV diastolic function was estimated by pulsed tissue Doppler imaging (TDI) echocardiography, averaging diastolic mitral annular velocity measurements (Em av, Am av, Em av/Am av ratio) from four separate sites (basal septal, lateral, anterior, and inferior LV wall). Moreover, aortic stiffness was evaluated by non-invasive carotid–femoral pulse wave velocity (c–f PWV) measurement.

Results

Hypertensives compared with normotensives exhibited greater LV mass index and Am av (110 versus 95 g/m 2 and 10 versus 8.8 cm/s, respectively, P< 0.001 for both cases), and greater c–f PWV (8.47 versus 7.48 m/s, P< 0.03), as well as lower Em av and Em av/Am av values,(8.4 versus 10 cm/s and 0.82 versus 1.15, respectively, P< 0.001 for both cases). In the group of hypertensives, a univariate analysis revealed that c–f PWV was negatively associated with Em av (r=− 0.305, P= 0.005), as well as with Em av/Am av ratio (r=− 0.437, P< 0.001). Moreover, a multivariate analysis showed that the TDI-derived Em av/Am av ratio was significantly associated with age (P= 0.001), relative wall thickness (P= 0.006) and c–f PWV (P= 0.03), while the conventional Doppler-derived E/A ratio was significantly associated only with age (P= 0.001).

Conclusions

TDI-detected LV diastolic dysfunction is accompanied by increased aortic stiffness in newly diagnosed essential hypertension, suggesting that there may be a common pathophysiological pathway linking these two entities.