Related Experiment Videos
Left ventricular mass is better correlated with arising blood pressure than with office or occasional blood pressure
P Gosse1, P Ansoborlo, P Lemetayer
1Hôpital Saint André, Bordeaux, France.
Insights
Morning blood pressure surges, particularly upon waking, correlate with increased left ventricular mass in hypertensive patients. This finding suggests rising blood pressure may contribute to heart complications.
Area of Science:
- Cardiology
- Hypertension Research
- Morphic Studies
Background:
- Cardiovascular complications often peak in the morning.
- An abrupt rise in blood pressure upon waking is suspected but not proven to be a risk factor.
- Existing research lacks data linking the magnitude of morning blood pressure elevation to cardiovascular risk.
Purpose of the Study:
- To investigate the correlation between blood pressure upon arising and left ventricular mass in untreated hypertensive individuals.
- To determine if morning blood pressure elevation is a significant predictor of cardiac structural changes.
Main Methods:
- Ambulatory blood pressure monitoring over 24 hours.
- Patient-triggered blood pressure readings immediately after arising.
- M-mode echocardiography to measure left ventricular mass, indexed for height and body surface area.
Main Results:
- Systolic blood pressure upon arising showed a stronger correlation with left ventricular mass index and wall thickness than office blood pressure.
- Multivariate analysis indicated that both systolic blood pressure upon arising and mean 24-hour systolic blood pressure independently predicted left ventricular mass and wall thickness.
Conclusions:
- Blood pressure upon arising is a significant factor in hypertensive patients.
- A substantial, sustained increase in blood pressure after waking may contribute to left ventricular hypertrophy.
- This morning blood pressure surge could be a trigger for cardiovascular events.
Abstract:
The peak incidence of cardiovascular complications in the morning points to a possible role of the abrupt increase in blood pressure on arising. However, there is as yet no firm evidence linking the extent of the elevation in blood pressure on arising and the risk of cardiovascular complications. We sought a correlation between blood pressure on arising and left ventricular mass in a population of 181 previously untreated hypertensive patients. Ambulatory blood pressure was measured over a 24-h period, and each patient was requested to trigger a blood pressure determination immediately after standing on arising in the morning. Left ventricular mass was measured with M-mode echocardiography and indexed for height, height(2.7), and body surface area. The systolic blood pressure on arising was significantly (P <.01) better correlated than office blood pressure with left ventricular mass index and wall thickness. On multivariate analysis, the values of systolic blood pressure on arising and mean 24-h systolic blood pressure contributed significantly and independently to the correlation with left ventricular mass and wall thickness. These observations point to the significance of the arising blood pressure. A marked abrupt daily elevation in blood pressure on arising, then maintained for a certain time, could contribute to the development of left ventricular hypertrophy and may constitute a trigger for cardiovascular complications.