Ambulatory blood pressure and left ventricular mass in alcohol-associated hypertension

Abstract

Twenty-five hypertensive male alcoholic patients and 25 men with mild-to-moderate essential hypertension underwent echocardiographic examination, followed by ambulatory blood pressure monitoring for 24 hours. (Twenty normotensive men served as controls.) The left ventricular mass index of the hypertensive alcoholic patients was significantly higher than that of the patients with essential hypertension ( P < 0.05) and that of the normotensive control subjects ( P < 0.001). Clinic and mean systolic and diastolic blood pressures obtained from the ambulatory blood pressure monitoring were similar for both the alcoholic and nonalcoholic hypertensive patients. The left ventricular mass index was significantly correlated with both daytime systolic ( r = .52; P < 0.01) and nighttime diastolic blood pressures ( r = .44; P < 0.05) in the patients with essential hypertension, but no relationship was found between echocardiographic findings and ambulatory blood pressure in the hypertensive alcoholic patients. A positive correlation between the left ventricular mass index and the duration of alcohol addiction was noted ( r = .54; P < 0.01). These findings suggest that nonhemodynamic factors play a prominent role in the pathogenesis of alcohol-related cardiac damage, even in the presence of hypertension. We recommend that echocardiography be included in the clinical assessment of alcoholic patients enrolled in a detoxification program.