Interrlationship between Left Ventricular Mass and Diurnal Variations of Blood Pressure in Patients with Esssntial Hypertension

Abstract

Background In hypertensive patients, the left ventricular hypertrophy LVH is very important as an independent risk factor along with developing complications. The present study was attempted to assess whether LVH assessed by echocardiography is related to diurnal variations of blood pressure in patients with essential hypertension.Methods After 24hr ambulatory blood pressure monitoring, echocardiographic parameters were investigated in 30 healthy normotensive subjects and 17 patients with diurnal variation of blood pressure and 19 patients without diurnal variation respectively.Results Left ventricular mass index was higher in essential hypertensive patients than normotensive subjects. In patients without nocturnal fall in systolic blood pressure, left ventricular mass tended to be higher than in patients with a nocturnal fall without statistic significance.In the hypertensive patients with nocturnal fall, there was a correlationship between LVMI and changes in systolic blood pressure, but no correlation between left ventricular mass index and changes in diastolic blood pressure.In the hypertensive patients without nocturnal fall, changes of both systolic and diastolic pressure did not affect LVMI.Conclusion It is suggested strongly that left ventricular hypertrophy may occur highly in the hypertensive patients without nocturnal diurnal variation in blood pressure and may be associated with changes in diastolic and systolic blood pressure.But in hypertensive patient with nocurnal fall, left ventricular hypertrophy may be associated with changes in systolic blood pressure.

Clinical Implications of Ambulatory and Home Blood Pressure Monitoring

“…In subjects with diminished or abolished fall in BP from day to night, not only left ventricular hypertrophy,31-34) but also silent cerebrovascular disease,35) microalbuminuria,36) and progression of renal damage30) were greater than in those with normal day-night BP difference.…”