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[The relationship between ambulatory blood pressure and left ventricular hypertrophy in essential hypertension]
1Shanghai Institute of Hypertension, Rui Jin Hospital, Shanghai Second Medical University.
Insights
Elevated ambulatory blood pressure (ABP), especially at night, contributes to left ventricular hypertrophy (LVH). Restoring normal blood pressure patterns may reverse LVH in hypertensive patients.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Imaging
Context:
- Investigated the link between ambulatory blood pressure (ABP) and left ventricular hypertrophy (LVH).
- Included 137 subjects: 54 healthy normotensives and 83 with essential hypertension.
- Utilized 24-hour noninvasive ABP monitoring and M-mode echocardiography.
Purpose:
- To determine the correlation between ABP levels and left ventricular mass index (LVMI).
- To assess the impact of circadian blood pressure variations on LVH development.
- To explore potential therapeutic targets for LVH reversal.
Summary:
- In hypertensive patients, LVMI significantly correlated with daytime and nighttime systolic and diastolic blood pressure (SBP and DBP).
- LVMI showed inverse correlations with the nocturnal reduction percentage of daytime SBP and DBP.
- Higher average ABP, particularly nighttime levels, and loss of circadian variation are implicated in LVH development.
Impact:
- Suggests that average ABP levels and disrupted circadian blood pressure patterns are key factors in LVH.
- Highlights the potential necessity of blood pressure control and restoring circadian variation for LVH reversal in hypertensive individuals.
Abstract:
The relationship between ambulatory blood pressure (ABP) and left ventricular hypertrophy (LVH) were investigated in 137 consecutive subjects (54 healthy normotensives and 83 uncomplicated patients with essential hypertension) who underwent 24-hour noninvasive ABP monitoring and M-mode echocardiography. In the normotensive group, left ventricular mass index (LVMI) was not correlated with average daytime (6AM-10PM) or nighttime (10PM-6AM) systolic and diastolic blood pressure (SBP and DBP) except for age (r = 0.405, P < 0.01). In the hypertensive group, however, LVMIs were significantly correlated with average daytime SBP (r = 0.315, P < 0.01), nighttime SBP (r = 0.408, P < 0.01) and DBP (r = 0.304, P < 0.01). Furthermore, significant inverse correlations were found between LVMI and percentage of nocturnal reduction of daytime SBP (r = -0.393, P < 0.01) and DBP (r = -0.308, P < 0.01). The results suggest that the average levels of ABP, particularly, the level of ABP during night and the loss of circadian variation of blood pressure, would be responsible for the development of LVH. The control of blood pressure and restoration of circadian blood pressure variation might be necessary for the reversal of LVH in hypertensive patients.