Mild hypertension in patients with suspected dilated cardiomyopathy: cause or consequence?

Abstract

This study was undertaken to clarify the relationship between mild transient hypertension and dilated cardiomyopathy. Fifty-five patients were studied: group 1 —controls (12 patients), group 2 —hypertensive s without clinical evidence of heart failure (14 patients), group 3 —patients with hypertensive heart failure and diastolic blood pressure above 1 (K) mmHg (10 patients), group 4 —patients with possible dilated cardiomyopathy with mild hypertension, i.e. diastolic blood pressure of 90-10 0 mmHg (8 patients), group 5 —patients with dilated cardiomyopathy and normal blood pressure (11 patients). The haemodynamic status and cardiac contractility indices were measured in each patient on admission, using M-mode echocardiography. Serum sodium and potassium as well as the urinary sodium, potassium and vanillyl mandelic acid excretion s were also measured. The stroke volume, cardiac output and cardiac index fell with heart failure, but much more remarkably in group 4. The peripheral vascular resistance was higher in groups 2, 3 and 4 than in groups 1 and 5; so also, were the aortic diameter. left posterior wall thickness and left ventricular mass. The plasma volume, aldosterone and Cortisol levels were higher and the urinary sodium and potassium excretion lower in patients with heart failure (groups 3, 4 and 5).