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Predictors of left ventricular hypertrophy in patients with essential hypertension
1Division of Cardiology, University of South Florida College of Medicine, Tampa 33612.
Insights
Blood pressure variability, not just high readings, predicts left ventricular hypertrophy in hypertensive patients. Longer hypertension duration further increases this risk, highlighting the need for comprehensive blood pressure monitoring.
Area of Science:
- Cardiology
- Hypertension Research
- Medical Diagnostics
Background:
- Mildly hypertensive patients often develop left ventricular hypertrophy.
- Echocardiography is a key tool for assessing cardiac structure.
- Predictive clinical variables for left ventricular hypertrophy require further investigation.
Purpose of the Study:
- To identify clinical variables predicting echocardiographic left ventricular hypertrophy in mildly hypertensive individuals.
- To evaluate the role of blood pressure variability in cardiac remodeling.
Main Methods:
- Studied 18 mildly hypertensive patients after 4 weeks of hydrochlorothiazide monotherapy.
- Assessed clinical variables including age, hypertension duration, BSA, cholesterol, lifestyle factors, and blood pressure.
- Measured blood pressure variability via hourly readings for 12 hours post-medication.
Main Results:
- Blood pressure variability was a significant predictor of elevated left ventricular mass index (p < 0.0003, r2 = 0.61).
- Hypertension duration significantly improved the prediction model (multiple r = 0.74).
Conclusions:
- Echocardiographic left ventricular hypertrophy in hypertensive patients is significantly associated with blood pressure variability.
- Hourly blood pressure monitoring after hydrochlorothiazide administration revealed predictive value.
- Both blood pressure variability and hypertension duration are crucial factors in predicting cardiac changes.
Abstract:
The purpose of this study was to assess clinical variables which might be predictive of echocardiographic left ventricular hypertrophy in mildly hypertensive patients. Eighteen patients (mean age 51) were studied following four weeks of hydrochlorothiazide monotherapy. Variables assessed included age, duration of hypertension, body surface area, serum cholesterol, alcohol consumption, smoking, maximum systolic and mean blood pressures, and variability of blood pressure determined from hourly measurements taken 12 hours after hydrochlorothiazide dosing. Using stepwise multiple linear regression (with left ventricular mass index analyzed as a continuous variable), the variability of blood pressure was predictive of an elevated left ventricular mass index (p less than 0.0003, r2 = 0.61). The duration of hypertension added significantly to the variability in predicting an elevated left ventricular mass index (p less than 0.004, multiple r = 0.74). In conclusion, echocardiographic left ventricular hypertrophy was significantly related to the variability of blood pressure recorded hourly for 12 h after subjects received 50 mg of hydrochlorothiazide.