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Published on: May 28, 2010
Ambulatory blood pressure monitoring and echocardiographic left ventricular wall thickness and mass
1Department of Medicine, Medical College of Georgia, Augusta 30912-3150.
Insights
24-hour ambulatory blood pressure monitoring is a superior predictor of cardiac target organ damage in hypertensive patients compared to office blood pressure readings. This finding highlights the importance of continuous monitoring for assessing cardiovascular risk.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Hypertension is a leading cause of cardiovascular disease.
- Cardiac target organ damage is a key indicator of hypertensive complications.
- Accurate blood pressure measurement is crucial for risk stratification.
Purpose of the Study:
- To evaluate the association between different blood pressure measurement methods and echocardiographic indices of cardiac damage in hypertensive patients.
- To determine the most effective blood pressure monitoring strategy for predicting hypertensive cardiac remodeling.
Main Methods:
- Assessed stable hypertensive patients.
- Compared 24-hour ambulatory blood pressure monitoring (ABPM) with office blood pressure (OBP) measurements.
- Utilized echocardiography to measure cardiac parameters like left atrial diameter and left ventricular mass.
Main Results:
- 24-hour ABPM, particularly diastolic pressure, significantly predicted posterior wall thickness, combined wall thickness, and relative wall thickness better than OBP.
- Significant correlations were observed between 24-hour systolic and diastolic blood pressure and various echocardiographic parameters, including combined wall thickness and left ventricular mass index.
- Left atrial dimension showed a significant association only with 24-hour average diastolic blood pressure.
Conclusions:
- 24-hour ambulatory blood pressure monitoring is a more robust predictor of hypertensive cardiac target organ damage than standard office measurements.
- Continuous blood pressure monitoring provides valuable insights into cardiac remodeling in hypertensive individuals.
- These findings support the use of ABPM for comprehensive cardiovascular risk assessment in hypertension management.
Abstract:
In a highly select group of stable hypertensive patients, we have assessed the strength of association between various blood pressure measurements (24 h average automated ambulatory blood pressure, 4 h automated ambulatory morning average blood pressure, multiple office visit average blood pressure, and a single office visit average blood pressure) and various echocardiographic indices of hypertensive cardiac target organ damage (left atrial diameter, left ventricular end diastolic diameter, posterior wall thickness, combined wall thickness, relative wall thickness, left ventricular mass and mass index, and combined wall thickness/left ventricular diastolic diameter ratio). These data demonstrated that a single 24 h average diastolic blood pressure by automatic noninvasive ambulatory monitoring was a significantly better predictor of echocardiographic posterior wall thickness, combined wall thickness or relative wall thickness than the multiple office or single office average diastolic blood pressure. Also there were highly significant correlations between both 24 h average systolic and diastolic blood pressure and these echocardiographic parameters (in descending order of correlation coefficient): combined wall thickness, posterior wall thickness, combined wall thickness/left ventricular diastolic diameter, left ventricular mass index, relative wall thickness, and left ventricular mass. Left ventricular end diastolic dimension did not linearly correlate with any systolic or diastolic blood pressure measurement. Left atrial dimension demonstrated only a significant association with 24 h average diastolic blood pressure. Single office average blood pressure did not linearly correlate with any echocardiographic parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
