Relationship between hypertensive left ventricular hypertrophy, neurohormonal factors and ventricular arrhythmias in very old patients

Abstract

Objective. — To study the relationship between hypertensive left ventricular hypertrophy (LVH) in very old patients (≥ 80 years) with neuro-hormonal factors and ventricular arrhythmias.

Methods — Heart rate variation, plasma renin(Ren), angiotensin-II (AT-II), aldosterone (Ald), insulin (Ins), Holter and ambulatory blood pressure monitoring were measured in 60 cases (≥ 80 years) which were divided into 2 groups: 30 with primary hypertension accompanied LVH in very old patients (group A); 30 with simple primary hypertension (group B).

Results — There was no significant difference of AT-II and Ren between group A and B (P = 0.05); Ins and Ald values in group A was much higher than in group B (P all < 0.01); the data of heart rate variability, including very low frequency (VLF) and low frequency (LF) and LF/HF (high frequency) in group A were significantly higher than in group B (P < 0.01, < 0.05, < 0.05, respectively); incidence of premature ventricular contractions (PVC) and myocardial ischaemia in group A were higher than in group B patients.

Conclusions — Sympathetic nerve excitability in group A was greatly increased; hypertensive LVH was closely associated with Ald and Ins level, but not with AT-II and Ren. Group A is characterized by a significantly greater frequency of premature ventricular contractions and ischaemia.

Key Words:

• hypertension
• elderly
• left ventricular hypertrophy
• neurohormones
• premature ventricular contractions
• myocardial ischaemia