Abstract 4901: Morning Hypertension is the Strong Predictor of Left Ventricular Remodeling in Never-Medicated Hypertensives

Abstract

We aimed this study to investigate the association between morning hypertension and left ventricular (LV) remodeling. This cross-sectional study enrolled consecutive 356 never-medicated hypertensives, and measured the LV mass and relative wall thickness using echocardiography. Home blood pressure (BP) was measured in the morning and evening for 14 consecutive days with a memory-equipped device. We divided all subjects into 4 groups according to the morning-evening difference in self-measured systolic BP (MEdif) and the average of morning and evening systolic BP (MEave): home normotension (MEave <135 mmHg and MEdif <15 mmHg), morning riser (MEave <135 mmHg and MEdif ≥15 mmHg), sustained hypertension (MEave ≥ 135 mmHg and MEdif <15 mmHg) and morning hypertension (MEave ≥ 135 mmHg and MEdif <15 mmHg). Morning hypertensives was significantly older than normotensives (70 years vs. 64 years, P<0.001). We compared distributions of LV remodeling patterns among the 4 groups ( Figure ). Concentric hypertrophy was more prevalent in morning hypertensives (48.6%) than in normotensives (7.8%, P<0.001), morning risers (20.0%, P = 0.007), and sustained hypertensives (30.0%, P = 0.003). Morning risers had higher percentage of concentric hypertrophy and concentric remodeling than normotensives (20% vs. 7.8%, P = 0.039; 32.5% vs. 14.7%, P = 0.017) despite similar MEave between the 2 groups. The association observed here between morning hypertension and concentric hypertrophy may be related to the mechanism of increased cardiovascular risk of morning hypertension.