Blood Pressure Variability and Left Ventricular Mass in Hypertensive Patients.

Abstract

Objectives The purpose of the study is to evaluate 24h blood pressure values by automatic ambulatory monitoring (ABPM) in a group of hypertensive patients already on therapy and to find correlations between different blood pressure parameters and the presence of left ventricular hypertrophy (LVH). Design and method: 39 patients diagnosed with essential hypertension grades 1-3 were enrolled in the study; echocardiography was done and left ventricular mass and mass index were calculated. Based on 24 h ABPM we calculated BP variability estimated as standard deviation (SD) and average real variability (ARV), pulse pressure, dipper profile and morning BP surge. We compared these parameters in pts with and without LVH and calculated correlations with LV mass. Results: Nocturnal diastolic BP variability estimated as SD had significantly higher values in pts with LVH (13,2 vs 9,9 mmHg, p=0,015), ARV/24 hour and ARV during nighttime had higher values in pts with LVH vs those with normal LV mass (12,25 vs 9,7 mmHg and 12,35 vs 9,36 mmHg, p=0,03). Nocturnal diastolic BP variability correlated with LV mass index (r=0,325 for ARV and r =0,327 for SD). Other variables did not correlate with LV mass. Conclusions Nocturnal diastolic BP variability correlates with LVH independently of mean BP value. ABPM offers a valueable analysis of BP and enables the calculation of different parameters- as variability- which predict target organ damage.