Hypertension and diastolic function

Abstract

1. Diastolic dysfunction is common in hypertension and is associated with dyspnea on exertion, fatigue, and exercise intolerance. 2. Hypertension, obesity, and diabetes mellitus are the most important cardiovascular risk factors for the development of diastolic heart failure in the elderly. 3. Physiologic stiffening of the great arteries is associated with an increase in systolic and a decrease in diastolic pressure, leading to left ventricular (LV) hypertrophy and physiologic diastolic dysfunction of the elderly. 4. Isolated systolic hypertension in the elderly is associated with diastolic heart failure typically seen in females with hypertensive heart disease (little old ladies' heart). 5. Patients with hypertensive heart disease and diastolic dysfunction benefit from angiotensinconverting enzyme inhibitors and angiotensin AT1 receptor blockers as well as lusitropic agents such as calcium antagonists. © 2008 Springer-Verlag London Limited.