Background: Left ventricular (LV) diastolic dysfunction with preserved systolic function is an echocardiographic finding in the early stage of arterial hypertension. Arterial stiffness is increased in hypertensives enhancing LV afterload. The aim of the study was to evaluate the relationship between LV diastolic dysfunction and arterial stiffness both in patients with essential hypertension (EH) and white coat hypertension (WCH).

Methods: We studied 200 consecutive patients with uncomplicated, newly diagnosed and never treated EH and 120 age-matched patients with WCH. All subjects underwent a transthoracic echocardiogram (TTE) in which the peak early diastolic to peak early systolic velocity ratio (E/A) was estimated using pulse wave doppler imaging of transmitral diastolic flow. Arterial stiffness was assessed by the measurement of carotid-femoral pulse wave velocity (PWVc-f) using the Complior SP device.

Results: PWVc-f values were higher in patients with ES compared to patients with WCH (7.81±1.38 vs 7.40±1.37 m/s, p = 0.01). In univariate analysis, PWVc-f was correlated with E/A ratio in both groups (r = −0.25, p = 0.0003 for patients with ES and r = −0.23, p = 0.01 for patients with WCH). After adjustment for age, PWVc-f sustained the independent association with E/A in the ES group (p = 0.04) but not in the WCH group as well (p = NS). In both groups, PWVc-f values were not related to LV systolic function indices (p = NS).

Conclusion: In patients with newly diagnosed essential hypertension, impaired LV diastolic filling is related to arterial stiffness independently of LV systolic function, while this association is weaker in patients with WCH.