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Relationship between ambulatory or exercise blood pressure and left ventricular structure: prognostic implications
1Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021.
Summary
Left ventricular mass, measured by echocardiography, is a key predictor of cardiovascular events. Blood pressure during activity, not clinic readings, better reflects this cardiac measure.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Diagnostic Imaging
Background:
- Left ventricular mass (LVM) is a critical indicator of cardiac health.
- LVM measured by echocardiography predicts cardiovascular events better than most risk factors, excluding age.
- Blood pressure (BP) monitoring methods influence their correlation with LVM.
Purpose of the Study:
- To evaluate the relationship between different blood pressure measurement techniques and left ventricular mass.
- To determine if activity-based BP measurements correlate better with LVM than casual BP readings.
- To explore the prognostic significance of LVM in cardiovascular risk assessment.
Main Methods:
- Echocardiography for accurate measurement of left ventricular mass.
- Ambulatory blood pressure monitoring (24-hour and daytime periods).
- Blood pressure assessment during maximal or submaximal exercise.
Main Results:
- Studies consistently show a stronger correlation between LVM and ambulatory BP compared to casual BP measurements.
- Blood pressure readings taken during physical or mental activity correlate better with LVM than clinic-based measurements.
- This suggests activity-related BP is a more sensitive indicator of cardiac structure.
Conclusions:
- Echocardiographic LVM serves as a valuable 'bioassay' for assessing the heart's response to BP.
- Activity-related BP measurements provide a more accurate reflection of cardiovascular structure than standard clinic readings.
- Further research into the mechanisms linking activity-induced BP and cardiac hypertrophy is warranted.