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Disparate relationships between blood pressure and left ventricular mass in patients with and without left
Insights
In hypertensive patients, whole-day blood pressure positively correlates with left ventricular (LV) mass only in those without LV hypertrophy. Other factors regulate LV mass in patients with existing cardiac hypertrophy.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- The link between casual blood pressure and left ventricular (LV) mass is weak in hypertension.
- Understanding factors influencing LV mass is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate the relationship between ambulatory blood pressure and LV mass in hypertensive patients.
- To determine if this relationship differs in patients with and without LV hypertrophy.
Main Methods:
- Utilized 24-hour ambulatory blood pressure monitoring.
- Assessed LV mass using M-mode echocardiography.
- Analyzed data from 33 hypertensive patients, categorizing them by LV hypertrophy presence.
Main Results:
- A significant positive correlation was found between whole-day systolic/diastolic blood pressure and LV mass in patients without LV hypertrophy.
- No significant correlation (systolic) or a significant negative correlation (diastolic) was observed between blood pressure and LV mass in patients with LV hypertrophy.
- 21 out of 33 hypertensive patients exhibited echocardiographic LV hypertrophy.
Conclusions:
- Ambulatory blood pressure positively correlates with LV mass solely in hypertensive individuals without cardiac hypertrophy.
- In hypertensive patients with LV hypertrophy, additional regulatory factors beyond blood pressure influence LV mass.
Abstract:
The relationship between casual blood pressure and left ventricular (LV) mass has been reported to be fairly weak in hypertensive patients. In this study we analyzed this relationship using noninvasive devices to monitor blood pressure for 24 hours in ambulatory patients and M-mode echocardiography to determine LV mass. Among the 33 patients with hypertension, 21 had echocardiographic LV hypertrophy (LV mass greater than 250 g). Patients with LV hypertrophy did not differ significantly from patients without hypertrophy with respect to age or casual systolic or diastolic blood pressure. The averages of whole-day systolic and diastolic blood pressures were 146 +/- 17 (SD) over 90 +/- 12 and 136 +/- 16 over 89 +/- 12 mm Hg, respectively. The relationship between whole-day average systolic blood pressure and LV mass was significantly positive (r = 0.66, p less than 0.05) in patients without hypertrophy but was not significant in patients with LV hypertrophy (r = -0.24). Similarly, the relationship between whole-day average diastolic blood pressure and LV mass was significantly positive in the former group (r = 0.64, p less than 0.05) but significantly negative in hypertensive patients with LV hypertrophy (r = -0.67, p less than 0.01). Thus, blood pressure correlates positively with LV mass only in patients without cardiac hypertrophy. In hypertensive patients with LV hypertrophy, factors additional to the high blood pressure itself must participate in the regulation of LV mass.