Related Experiment Videos
Twenty-four hour arterial pressure and heart rate as predictors of left-ventricular hypertrophy
1Department of Internal Medicine B, Barzilai Medical Center, Israel.
Insights
Hypertension patients with left-ventricular hypertrophy (LVH) show higher 24-hour arterial pressure (AP) and altered heart rate (HR) responses compared to those without LVH. Left-ventricular mass did not correlate with AP but showed a negative correlation with HR.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Physiology
Background:
- Left-ventricular hypertrophy (LVH) is a known complication of hypertension, but its relationship with arterial pressure (AP) and heart rate (HR) dynamics is not fully understood.
- Variability in LVH among hypertensive patients suggests underlying differences in cardiovascular response.
- Understanding these differences is crucial for personalized hypertension management.
Purpose of the Study:
- To investigate differences in 24-hour AP and HR, and AP response to physical stress between hypertensive groups with and without LVH.
- To determine correlations between AP, HR (at rest, under stress, and during 24-hour monitoring), and left-ventricular mass (LVM).
Main Methods:
- Comparison of two matched hypertensive groups: one with LVH (study group) and one without LVH (control group).
- Office and 24-hour ambulatory arterial pressure (AP) and heart rate (HR) monitoring.
- Assessment of AP response during bicycle ergometry following a washout period of antihypertensive medication.
Main Results:
- The LVH group exhibited significantly higher 24-hour AP during both day and night compared to the control group.
- The control group displayed significantly faster HR in the clinic and at night, and a blunted HR response to exercise.
- Maximal AP and AP increase during exercise did not differ between groups; LVM index did not correlate with office or maximal AP, but negatively correlated with office HR and pre-exercise HR.
Conclusions:
- Hypertensive patients with LVH have elevated 24-hour AP and distinct HR patterns compared to those without LVH.
- Ambulatory AP monitoring is essential for revealing AP differences not apparent in office measurements.
- HR, rather than AP, may be a more sensitive indicator of LVM in hypertensive individuals.
Abstract:
Hypertrophy of the left ventricle occurs in some but not all hypertensive patients. The present study was designed to examine the office and the 24-hour arterial pressure (AP) and heart rate (HR) recordings, and the AP response to physical stress in two age- and sex-matched hypertensive groups who differed in their left-ventricular mass (LVM). In addition, we tried to determine whether AP and HR measured at rest, under stress, or with 24-hour AP monitoring correlate with LVM. Ten hypertensive subjects with left-ventricular hypertrophy (LVH) made up the study group and 10 hypertensive subjects without LVH made up the control group. Antihypertensive medication was withdrawn at least four weeks prior to evaluation. The mean office AP measured during the washout period was 157 +/- 13/100 +/- 11 mm Hg in the study group and 157 +/- 17/104 +/- 7 mm Hg in the control group. However, 24-hour AP monitoring disclosed that the study group had significantly higher AP than the control group during both day and night. The control group had a significantly faster HR in the clinic and at night. The HR response to bicycle exercise was less in the control group than in the LVH group. The maximal AP and the rise in AP during bicycle exercise did not differ between groups. The LVM index did not correlate with the office AP or with maximal AP during effort, but did correlate negatively with the office HR and with the HR prior to the exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)