Echocardiographic diastolic dysfunction among hypertensive patients

  • Halgurd F. Ahmed Department of Internal Medicine, Rozh-halat Emergency Hospital, Erbil, Iraq.
Keywords: Diastolic dysfunction, Left ventricular hypertrophy, Echocardiography, Hypertension


Background and objective: Hypertension is a very common medical disorder, affecting nearly 40% of our population. Diastolic dysfunction is one of complications that happens and is regarded as a predictive of subsequent heart failure. The aim of this study was to determine the frequency of left ventricular diastolic dysfunction by echocardiography among hypertensive patients. Methods: This study involved 150 hypertensive cases (82 female and 68 male) age from 25-81 years old. Transthoracic echocardiography approach, using SIEMENS SONOLINE Omnia 2005 machine with the probe of p4-2 was used by the researcher. A comparative 150 normal non-hypertensive healthy adults with hypertensive patients are examined again by echocardiography. The parameter for the diastolic dysfunction measurement is E/A ratio. Results: It was found that 88 (58.7%) of hypertensive patients have diastolic dysfunction, while 4.9% of non-hypertensive group have diastolic dysfunction with significant statistical differences between both groups (P <0.001), who were age >60years have 79%, while age 25-35years old have 21% (P <0.001). Among left ventricular hypertrophy patients, 87.5%, versus 12.5% have diastolic dysfunction (P <0.001). Females are more liable for diastolic dysfunction, who have 70.7% than males who have 44.1% (P <0.001). Conclusion: Diastolic dysfunction is common among hypertensive patients, particularly among females, aged, and who have echocardiographic criteria of left ventricular hypertrophy, represent risk factors for diastolic dysfunction.


Thais C, Barry A, Patricia A, Stephen T, Iftikhar J. Sex Differences in Arterial Stiffness and Ventricular-Arterial Interactions. J Am Coll Cardiol 2013; 61(1):96-103.

Aaron M, Christopher G,Horng H. The Development of Heart Failure in Patients with Diabetes Mellitus and Pre-Clinical Diastolic Dysfunction : A Population-Based Study. J Am Coll Cardiol 2010; 55(4):300-5.

Paul M, John A, Lisa C, Sherry L, Lynn K, Kent R,et al. Impaired Natriuretic and Renal Endocrine Response to Acute Volume Expansion in Pre-Clinical Systolic and Diastolic Dysfunction. J Am CollCardiol 2011;58(20):2095-103.

Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction, N Engl J Med 2006; 355 :251-9

Frank E,Götz G, Hans-Dirk D, Stefan F, Rolf W, Raoul S,et al. Exercise Training Improves Exercise Capacity and Diastolic Function in Patients with Heart Failure with Preserved Ejection Fraction: Results of the Ex-DHF (Exercise training in Diastolic Heart Failure) Pilot Study.J Am Coll Cardiol 2011; 58(17):1780-91.

Rowlens M,Rakesh M, James B, Kent R, Naser M, Jae K, et al. Diastolic Dysfunction in Patients Undergoing Cardiac Surgery: A Pathophysiological Mechanism Underlying the Initiation of New-Onset Post-Operative Atrial Fibrillation. J Am CollCardiol 2011; 58(9):953-61.

Abdul Rashid K, Muhammad Q. Association and pattern of diastolic dysfunction in patients of metabolic syndrome.J Ayub Med Coll Abbottabad 2008; 20(2):70-5

Patil M, Burji N, Echocardiographic evaluation of diastolic dysfunction in hypertensive patients. J Assoc Physicians India 2012; 60:23-6.

The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.US Department of Health and Human Services./guidelines/hypertension/jnc8.Accessed January 6, 2014.

Meijs M, Bots M,Vonken E, Cramer M, Melman P,Velthuis B, et al. A prediction model for left ventricular hypertrophy in hypertension.Neth Heart J 2007;15(9): 295–8.

TromsS.Mitral flow derived Doppler indices of left ventricular diastolic function. Eur.heart J 2000; 21: 1376-86

Levy D, Larson M,Vasan R, Kannel W. The progression from hypertension to congestive heart failure. JAMA 1996; 275:1557-62.

Donald M, LarsonM,Leip E. Lifetime risk for developing congestive heart failure. Circulation.2002; 106:3068-9.

Masoudi F,Havranek E, Smith G. Gender, age, and heart failure with preserved left ventricular systolic function. J Am Coll Cardiol 2003; 41:217-22.

Drazner MH, Rame JE, Marino EK, Gottdiener JS, Kitzman DW, Gardin JM, et al. Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. J Am CollCardiol 2004; 43:2207-15.

Koren M, Devereux R, Casale P. Role of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991; 114:345-8.

Che Q, Martin J, Mohammed A. Beta-blockers for hypertension: Are they going out of style? Cleve Clin J Med 2009; 76(9):533-42.

- Warner J, Metzger C, Kitzman D. Losartan improve exercise tolerance in patients with diastolic dysfunction and hypertensive response to exercise. J Am Coll Cardiol 1999; 33:1567-71.

William W, Parmley M. Efficacy and Safety of Calcium Channel Blockers in Hypertensive Patients with Concomitant Left Ventricular Dysfunction. Clin. Cardiol 1992; 15:235-42.

Mottram P, Haluska B, Leano R. Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure. Circulation 2004; 110:558-63.

How to Cite
Ahmed, H. (2018). Echocardiographic diastolic dysfunction among hypertensive patients. Zanco Journal of Medical Sciences (Zanco J Med Sci), 19(1), 853_858.
Original Articles