Abstract P117: Association Of Ambulatory Blood Pressure Monitoring Parameters With Left Ventricular Hypertrophy: Analysis Of Pooled Population- And Community-based Studies

Abstract

Objectives: Ambulatory blood pressure (BP) monitoring (ABPM) parameters beyond mean BP may be useful for identifying individuals at high risk for cardiovascular end-organ damage. We examined the association between ABPM parameters, including 24-hour BP load, peak BP, peak increase in BP, and mean BP with left ventricular hypertrophy (LVH). Methods: Data were pooled from five US-based studies in which participants underwent ABPM for 24 hours (n=2,892). We defined systolic BP (SBP) load as the weighted average of the percent awake SBP readings ≥ 130 mm Hg and asleep SBP readings ≥ 110 mm Hg; peak SBP as the weighted average of awake and asleep 90 th percentile of SBP; peak increase as the difference between the peak SBP and mean SBP. These parameters were then categorized into quartiles. LVH was assessed by 2D-echocardiography. Analyses were stratified by mean 24-hour BP < 130/80 and ≥ 130/80 mm Hg. Results: Among participants with mean 24-hour BP < 130/80 mm Hg, the prevalence of LVH increased from the lowest to the highest quartile for SBP load, peak SBP, peak increase in SBP, and mean SBP ( Table ). The adjusted prevalence ratio (PR) for the association of the highest versus the lowest quartile with LVH was 1.82 (95%CI: 1.08-3.05) for SBP load, 2.00 (95%CI: 1.18-3.38) for peak SBP, 1.38 (95%CI: 0.85-2.23) for peak increase in SBP, and 1.51 (95%CI: 0.98-2.32) for mean SBP. Among participants with mean 24-hour BP ≥ 130/80 mm Hg, the prevalence of LVH increased for all ABPM parameters from the lowest to the highest quartile. The multivariable-adjusted PR for the association of the highest versus the lowest quartile with LVH was 1.39 (95%CI: 0.98-1.97) for SBP load, 1.66 (95%CI: 1.09-2.53) for peak SBP, 1.08 (95%CI: 0.76-1.53) for peak increase in SBP, and 1.88 (95%CI: 1.24-2.83) for mean SBP. Conclusion: The 24-hour SBP load and peak SBP were associated with a higher prevalence of LVH when mean 24-hour BP was < 130/80 mm Hg. The 24-hour peak SBP and mean SBP were associated with a higher prevalence of LVH when mean 24-hour BP was ≥ 130/80 mm Hg.