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Relation of arterial pressure level and variability to left ventricular geometry in normotensive and hypertensive

Bhatt1, James, Pickering

  • 1Cardiovascular Center and Department of Medicine, The New York Hospital-Cornell Medical Center, New York, New York, USA.

Blood Pressure Monitoring
|October 1, 1996
PubMed

Insights

Ambulatory blood pressure monitoring, not clinic readings, better predicts adverse left ventricular geometry in hypertensive patients. Blood pressure variability, not just high levels, significantly impacts heart structure.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Left ventricular geometry is crucial for cardiovascular prognosis.
  • Hypertension is a major risk factor for adverse cardiac remodeling.
  • Understanding the relationship between blood pressure patterns and cardiac structure is vital.

Purpose of the Study:

  • To evaluate how blood pressure levels and variability influence left ventricular geometry.
  • To compare the impact of ambulatory versus clinic blood pressure measurements on cardiac structure.

Main Methods:

  • Utilized 24-hour ambulatory blood pressure monitoring (systolic and diastolic) and echocardiography.
  • Analyzed data from 76 normotensive and 245 hypertensive adults.
  • Correlated blood pressure metrics with left ventricular geometry, including concentric and eccentric hypertrophy.

Main Results:

  • Hypertensive patients with concentric hypertrophy showed greater differences in ambulatory blood pressure compared to clinic readings.
  • The white-coat effect was most pronounced in eccentric hypertrophy; concentric hypertrophy was linked to increased ambulatory blood pressure variability.
  • Ambulatory systolic blood pressure most strongly correlated with left ventricle mass, and ambulatory diastolic blood pressure with relative wall thickness.

Conclusions:

  • Ambulatory blood pressure level and variability are more strongly associated with adverse left ventricular geometric adaptations than clinic measurements.
  • These findings highlight the importance of 24-hour monitoring for assessing cardiovascular risk.
  • No association was found between adverse left ventricular geometry and loss of the nocturnal blood pressure dip.

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