Left ventricular hypertrophy in hypertensive patients with different ambulatory monitoring daily pattern

Abstract

The aim of the present study was to try to identify which parameters of blood pressure (BP) ambulatory monitoring are better related to the presence of left ventricular hypertrophy in hypertensives.

Fifty-six ambulatory hypertensive patients were investigated. Patients were subdivided into two groups of comparable casual and twenty-four-hour ambulatory pressure but with different nighttime decrements of the mean BP (respectively>10%, n=29, and ≤10%, n=27). When all the patients were considered, no significant correlation between left ventricular mass index (LVMI) and casual pressure values was found. On the contrary significant relationships between LVMI and systolic ambulatory twenty-four-hour (p<0.01), daytime (p<0.01), and nighttime (p<0.001) pressures, but not with diastolic pressures, were found.

The interventricular septum (P<0.03) and the LVMI (P<0.03) respectively measured and calculated by echocardiography, were significantly larger in patients with limited pressure fall at nighttime.

The extent of BP fall at nighttime assessed by ambulatory monitoring seems, therefore, to permit identification of hypertensive patients at higher cardiovascular risk.