Gender differences in the relationship between left ventricular size and ambulatory blood pressure in borderline hypertension: The HARVEST Study

AIM: To assess whether there are gender differences in cardiac adaptationto raised blood pressure levels in young subjects with borderlineto mild hypertension. METHODS AND RESULTS: In 499 18–45-year-old stage I hypertensive subjects (377men and 122 women) with a mean age of 33±9 years andoffice blood pressure of 146±11/94±6 mmHg, ambulatoryblood pressure monitoring in duplicate, echocardiography and24-h urinary catecholamines measurement were performed. RESULTS: The whole group was divided into quartiles of increasing daytimeblood pressure and differences in left ventricular echocardiographicdata were analysed in the two sexes separately. In men no leftventricular parameter differed across the quartiles, while inwomen left ventricular mass, posterior wall thickness and interventricularseptum thickness showed a clear tendency to increase with increasinglevels of systolic blood pressure. In multiple regression analysis,daytime systolic blood pressure explained only a small fractionof the variance in left ventricular parameters in men, whilein women daytime systolic blood pressure was a main determinantof left ventricular mass and posterior wall and septal thicknesses.Body weight explained most of the variance in all dimensionalparameters in men. In women weight was an important predictorof left ventricular mass and diameter, but was unrelated toleft ventricular posterior wall and septal thicknesses. CONCLUSIONS: Daytime systolic blood pressure is the most important predictorof left ventricular mass and geometry in pre-menopausal womenwith stage I hypertension, while in men left ventricular dimensionalindeces are chiefly explained by body weight.