Related Experiment Videos
High night blood pressure in treated hypertensive patients: not harmless
P Gosse1, G Campello, R Roudaut
1Hôpital Cardiologique Centre Hospitalier Régional et Universitaire de Bordeaux, Pessac, France.
Insights
Nighttime blood pressure (BP) significantly impacts left ventricular mass index (LVMI) in treated hypertensive patients. Twenty-four-hour BP monitoring is crucial for assessing adequate BP control and identifying persistent left ventricular hypertrophy (LVH).
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Monitoring
Background:
- Left ventricular mass index (LVMI) is a key indicator of cardiac health in hypertensive patients.
- Current recommendations often focus on daytime ambulatory blood pressure (BP) monitoring.
- The role of nighttime BP in relation to LVMI in treated versus untreated hypertensive individuals requires further investigation.
Purpose of the Study:
- To investigate the influence of nighttime blood pressure on LVMI in treated versus untreated hypertensive patients.
- To compare the correlation between daytime and nighttime BP and LVMI in different patient groups.
- To assess the utility of 24-hour BP monitoring in managing treated hypertension.
Main Methods:
- Comparison of two groups: 40 untreated hypertensive patients and 24 treated hypertensive patients.
- Ambulatory BP monitoring recorded every 15 minutes during the day and every 30 minutes at night.
- LVMI calculated using M-mode echocardiography and Devereux's formula.
Main Results:
- In untreated patients (Group A), daytime systolic BP showed a stronger correlation with LVMI than casual or nighttime BP.
- In treated patients (Group B), a significantly higher correlation was observed between nighttime BP and LVMI, despite lower average nighttime BP levels.
- Daytime BP was a better predictor of LVMI in untreated patients, while nighttime BP was more strongly associated in treated patients.
Conclusions:
- Twenty-four-hour BP monitoring is valuable for assessing BP control in treated hypertensive patients.
- Inadequate reduction of nighttime BP may contribute to persistent left ventricular hypertrophy (LVH) in treated hypertensive individuals.
- Targeting nighttime BP may be essential for comprehensive management of hypertension and prevention of cardiac remodeling.
Unlabelled:
The left ventricular mass index (LVMI) is better related to activity than resting systolic blood pressure (BP) in treated hypertensive patients. Many recommend ambulatory BP monitoring only during the day. However, 24-hour BP monitoring may be useful in treated patients to check adequate control of BP during the entire 24-hour period. We tested the influence of night BP on LVMI in treated versus nontreated patients. We compared two groups of hypertensive patients: A: 40 patients who had discontinued therapy at least 8 days prior to the study; B: 24 patients treated for more than 3 months with the same drugs (beta-blockers in 14 cases). Ambulatory BP was recorded every 30 minutes during night and every 15 minutes during day (Spacelabs 5200). The LVMI was calculated from M mode echo blind reading (Devereux's formula). Correlation coefficients between LVMI and casual, systolic BP were calculated for both day (7:00 AM to 10:59 PM) and night time (11:00 PM to 6:59 AM). Day systolic BP is better related to LVMI than casual and night systolic BP in group A. In contrast, a significantly higher correlation existed between night BP and LVMI in B, though average night BP level was lower.
Conclusion:
24-hour BP monitoring may be useful in treated hypertensive patients. Inadequate lowering of night BP may partially account for persistent LVH in treated hypertensive patients.