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Left ventricular hypertrophy and ambulatory monitoring of blood pressure
Insights
Continuous blood pressure monitoring reveals higher night-time systolic pressure in patients with left ventricular hypertrophy (LVH), suggesting a stronger link than traditional cuff measurements. This finding may impact hypertension treatment strategies.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Monitoring
Background:
- The relationship between left ventricular hypertrophy (LVH) and standard cuff blood pressure (BP) measurements is often weaker than expected.
- Continuous BP monitoring has shown a better correlation with LVH compared to intermittent cuff readings.
Purpose of the Study:
- To investigate the correlation between LVH and continuous intra-arterial ambulatory BP monitoring.
- To compare BP patterns in essential hypertension (EH) patients with and without LVH.
Main Methods:
- Continuous intra-arterial ambulatory BP monitoring (Oxford technique) was performed.
- 10 EH patients with LVH and 10 age-matched EH patients with normal left ventricles (NLV) were studied.
- BP and heart rate were continuously monitored over 24 hours.
Main Results:
- Average cuff BP did not significantly differ between the LVH and NLV groups.
- Intra-arterial monitoring revealed significantly higher 24-hour and night-time (6 PM-6 AM) systolic BP in the LVH group.
- Night-time systolic BP showed a significant correlation with the thickness of the interventricular septum and left ventricular posterior wall (LVPW).
Conclusions:
- Continuous intra-arterial BP monitoring provides a more accurate assessment of BP in relation to LVH than cuff BP.
- Elevated night-time systolic BP is a key indicator associated with LVH in essential hypertension.
- These findings may have implications for hypertension management, warranting further investigation in larger patient cohorts.
Abstract:
Left ventricular hypertrophy (LVH) and cuff blood pressure (BP) level are not as closely related as one might suppose. A better correlation was reported between LVH and continuous monitoring of BP. To analyze this relationship we performed continuous intra-arterial ambulatory monitoring (Oxford technique) in 10 patients with essential hypertension (EH) having LVH, and in 10 age-matched EH patients with normal left ventricles (NLV). Average cuff BP did not differ significantly between the two groups. The intra-arterial BP monitoring showed a significantly higher systolic BP in EH patients with LVH for the mean of the 24 hours (p less than .05) and in the 6 PM-6 AM (night) period (p less than .01); whereas the difference was not significant for the mean systolic BP of the 6 AM-6 PM (day) period and for the mean 24-hour diastolic BP. The heart rate was similar between the two groups; however, the variability of BP was not different. The night systolic BP correlated with the thickness of interventricular septum plus left ventricular posterior wall (LVPW) (r = 0.66; p less than .05). These results may have therapeutic implications, although they require confirmations in a larger series of patients.