AMBULATORY BLOOD-PRESSURE AND ECHOCARDIOGRAPHIC LEFT-VENTRICULAR DIMENSIONS IN ELDERLY HYPERTENSIVE SUBJECTS

In a consecutive series of 62 hypertensive elderly subjects, the autho rs studied the relation of blood pressure circadian variations with ec hocardiographic parameters of left ventricular (LV) hypertrophy. All t he subjects were submitted to an ambulatory blood pressure monitoring (ABPM) and to B- and M-mode echocardiography. In the elderly hypertens ive group, LV mass index (LVMI) was more strongly related to twenty-fo ur-hour, daytime and nighttime systolic ambulatory blood pressure (r = 0.52, r = 0.37, r = 0.51) than diastolic ambulatory blood pressures w ere (r = 0.32, r = 0.18, r = 0.33). Casual systolic and diastolic bloo d pressure (CBP) was found more weakly related to LVMI than ambulatory blood pressures were (r = 0.35, r = 0.26). Elderly hypertensive subje cts were divided into two subgroups in relation to the presence (group 1) or absence (group 2) of blood pressure nocturnal decline. No diffe rences were found between these two subgroups in regard to: casual blo od pressure values, ambulatory blood pressures in the diurnal period, sex, body surface area, height, weight, and age. LVMIs were computed i n all three groups and showed the following results: 89.32 +/- 19.76 i n elderly normotensives, 91.21 +/- 31.32 in group 1, and 99.80 +/- 18. 21 in group 2. Echocardiographic parameters of LV dimensions and LVMIs were different in group 1 and 2. An inverse correlation, statisticall y significant, was observed between LVMIs and the nocturnal blood pres sure reduction (systolic: r = -0.36, P < 0.05; diastolic: r = -0.29, P < 0.05). These results suggest an association between a smaller LV ma ss and nocturnal blood pressure decline in elderly hypertensive patien ts.