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Left ventricular mass predicted by a single reading of ambulatory blood pressure in essential hypertension
S Ohmori1, K Matsumura, T Kajioka
1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Insights
Ambulatory systolic blood pressure during heightened sympathetic nervous system activity can predict left ventricular mass in essential hypertension patients. This finding highlights the link between blood pressure, autonomic function, and cardiac structure in hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Autonomic Nervous System Studies
Background:
- Left ventricular mass (LVM) negatively correlates with heart rate variability (HRV) spectral power.
- Essential hypertension may involve autonomic dysfunction linked to left ventricular hypertrophy.
- Simultaneous assessment of autonomic function, ambulatory blood pressure, and LVM is lacking.
Purpose of the Study:
- To investigate the combined impact of ambulatory blood pressure and autonomic nerve activity on the heart.
- To explore the relationship between LVM, autonomic function, and blood pressure patterns in essential hypertension.
Main Methods:
- 25 untreated essential hypertension patients underwent 24-hour ambulatory blood pressure and HRV monitoring.
- Spectral analysis of HRV yielded high-frequency (HF) and low-frequency (LF) power, with LF/HF ratio indicating sympathetic/parasympathetic balance.
- Left ventricular mass index (LVMi) was assessed via echocardiography.
Main Results:
- Daytime and nighttime systolic ambulatory blood pressures correlated significantly with LVM index, unlike clinic blood pressures.
- A single ambulatory systolic blood pressure reading during peak sympathetic activity (high LF/HF ratio) strongly correlated with LVM index.
- This correlation was independent of patient age and sex.
Conclusions:
- Ambulatory blood pressure, particularly during sympathetic surges, is a valuable indicator of LVM in essential hypertension.
- Autonomic nervous system activity plays a crucial role in the relationship between blood pressure and cardiac remodeling.
- Findings suggest ambulatory blood pressure monitoring during specific autonomic states can help assess cardiac structural changes in hypertension.
Abstract:
The spectral power of heart rate variability has been shown to be negatively correlated with left ventricular mass (LVM), suggesting the contribution of left ventricular hypertrophy to autonomic dysfunction in essential hypertension. However, a simultaneous assessment of autonomic function and ambulatory blood pressure in relation to LVM has not been carried out. The objective of the present study was to elucidate the synergistic effects of ambulatory blood pressure and autonomic nerve activity on the heart. We enrolled 25 ambulant patients with untreated essential hypertension (9 men and 16 women; mean age 50.6 +/- 2.0 years). The ambulatory blood pressure and heart rate variability were simultaneously monitored every 30 min for 24 h. The spectral power of high-frequency (HF: 0.15 to 0.4 Hz) and low-frequency (LF: 0.05 to 0.15 Hz) bands were measured, and the ratio of LF to HF (LF/HF) was calculated. LF/HF and HF were used as indexes of sympathetic and parasympathetic activities, respectively. LVM was determined by echocardiography. Both the average daytime and nighttime systolic ambulatory blood pressures significantly correlated with the LVM index (r= 0.644, p< 0.001; and r= 0.428, p< 0.05; respectively), although there was no such correlation with the clinic blood pressures. In contrast, a single reading of ambulatory systolic blood pressure measured when LF/HF reached a maximum value was significantly correlated with the LVM index independently of age and sex (partial r= 0.484, p< 0.05). These results suggest that the ambulatory systolic blood pressure during increases in the activity of the sympathetic nervous system is able to infer LVM in essential hypertension.