Related Experiment Videos
[Ambulatory arterial pressure and left ventricular hypertrophy in untreated hypertensive patients]
J M Pascual1, E Baldó, V Bertolín
1Servicio de Medicina Interna, Hospital de Sagunto, Valencia.
Insights
In never-treated hypertensive individuals, elevated 24-hour systolic blood pressure is the primary factor linked to left ventricular hypertrophy (LVH). This finding highlights the importance of continuous blood pressure monitoring for managing LVH risk.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Left ventricular hypertrophy (LVH) is a significant cardiovascular complication of hypertension.
- Understanding factors associated with LVH is crucial for early intervention in hypertensive patients.
- This study focuses on never-treated, middle-aged individuals to isolate the impact of blood pressure on LVH.
Purpose of the Study:
- To evaluate the relationship between blood pressure (BP) values and left ventricular hypertrophy (LVH).
- To identify key BP parameters associated with LVH in untreated middle-aged hypertensive subjects.
- To assess the predictive value of ambulatory BP monitoring for LVH.
Main Methods:
- 149 never-treated hypertensive patients (25-50 years) underwent ambulatory blood pressure monitoring (ABPM) and echocardiography.
- Left ventricular mass (LVM) was calculated, with LVH defined by sex-specific thresholds (>134 g/m² for males, >110 g/m² for females).
- Statistical analyses, including multiple regression, were used to determine associations between BP parameters and LVH.
Main Results:
- 43% of the study population exhibited LVH.
- Patients with LVH showed significantly higher clinic and 24-hour systolic and diastolic BP values.
- 24-hour systolic blood pressure (SBP) and sex were independently associated with LVH; an SBP > 150 mmHg significantly increased LVH risk (OR=9.2).
Conclusions:
- 24-hour systolic blood pressure is the principal determinant of left ventricular hypertrophy in middle-aged, never-treated essential hypertensive patients.
- Ambulatory BP monitoring is valuable for assessing LVH risk in this population.
- These findings underscore the importance of controlling 24-hour SBP to prevent cardiac remodeling in hypertension.
Background:
The study was designed to evaluate blood pressure (BP) values related to left ventricular hypertrophy (LVH) in a group of never treated middle-aged hypertensive subjects.
Patients And Method:
Non-invasive ambulatory blood pressure monitoring (ABPM) and echocardiography were performed in 149 hypertensive patients (25-50 years old) with diastolic blood pressure (DBP) 90-114 mmHg. LVH was considered when left ventricular mass (LVM) was > 134 g/m2 in males and > 110 g/m2 in females.
Results:
43% of patients had LVH. Patients with LVH had higher clinic and ambulatory BP values. The greatest differences were in mean 24-h SBP (p = 0.001) and in 24-h DBP (p = 0.006). With respect to LVH, there were no differences between dippers and non-dippers, males or females, and circadian or BP variability. LVM was positively correlated with clinical DBP (p = 0.24), 24 h SBP (p = 0.41), pulse pressure (PP) (p = 0.36) and absolute BP variability (p = 0.23). Multiple regression analysis confirmed that 24-h SBP and sex where positively associated with LVH independent of others factors. The existence of 24-h SBP > 150 mmHg dramatically increased the risk of LVH (odds ratio [OR] = 9.2; CI 95%: 2.8-29.3; p = 0.002).
Conclusions:
The present study indicates that in never treated middle-aged essential hypertensive patients the principal factor related to the presence of LVH is the value of systolic blood pressure throughout a 24-h period.