:Dimensions by Echocardiography, with Special Reference to the Changes in Blood Pressure Over a Ten Year Period
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概要
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Echocardiographic examinations were performed on 701 asymptomatic males, aged 40 to 59, with over a ten year period examinations in geographically, occupationally different three populations: farmers in Akita; manual workers in Osaka; and clerical workers in Osaka. The subjects were classified into seven blood pressure groups by the changes in blood pressure and ST-T change on ECG for the past ten years. The following results were obtained. (1) LV end-diastolic diameter (LVDd) did not differ significantly in the hypertensive groups as compared with the normotensive group in the two population groups from Osaka. However, in the Akita farmers, LVDd was significantly smaller in the hypertensive groups with hypertension for the past ten years or ST-T change on ECG as compared with the normotensive group. The thickness of the interventricular septum (IVST) and of the LV posterior wall (LVPWT) and the ratio of LVPWT to the LV radius had a significant and progressive increase with the progression of hypertension and ST-T change on ECG in each population group. Concentric LV hypertrophy parallels the progression of severity of hypertension. Asymmetric septal hypertrophy (IVST/LVPWT ≥1.3) was shown in 4.3% in the hypertensive group with ST-T change on ECG, but groups of normotension, borderline hypertension and hypertension without ST-T change on ECG showed no asymmetric septal hypertrophy. These findings demonstrate that both IVST and LVPWT were secondary to a progressive increase in pressure load. Left ventricle had symmetric hypertrophy, except for the hypertensive group with ST-T change on ECG. (2) The Akita farmers, in each blood pressure group, had the greatest LVDd, IVST and LVPWT in comparisons to the manual and clerical workers from Osaka. For the two Osaka groups, these three variables were greater for the manual workers. These comparisons indicate that the more physically active population has the greater LV dimension in each blood pressure group. Large differences of LV dimension were found among the three population groups in normotensives, but these differences were obscured with the progression of hypertension. But both IVST and LVPWT were greater in the more physically active population as compared to the population with less physical activity even with the progression of hypertension. These results suggest that strenuous physical labor has a harmful influence on left ventricle of hypertensives.
- 社団法人 日本老年医学会の論文