RELATION OF CIRCADIAN BLOOD-PRESSURE CHAN GES TO LEFT-VENTRICULAR HYPERTROPHY IN ESSENTIAL-HYPERTENSION

Aim of the study was to answer the question whether changes in the diu rnal blood pressure pattern will show a relation to hemodynamic, echoc ardiographic or endocrine parameters in men and women with essential h ypertension. Therefore we conducted 24-h blood pressure measurements ( Delmar Avionics), invasive hemodynamic measurements, and 2D-guided M-m ode echocardiography in 20 female and 46 male untreated essential hype rtensives. In addition, we determined noradrenaline, adrenaline, and p lasma renin activity. The female and male study group were divided int o two groups according to presence (>>dippers<<) or absence (>>non-dip pers<<) of a nocturnal reduction of mean blood pressure (BP) by 10% or more of daytime values. In both sex groups dippers and non-dippers we re characterized by similar casual blood pressure, body weight, and bo dy surface area. No significant differences were observed between the two groups with regard to renal and systemic vascular resistance. Furt hermore, endocrine parameters were comparable in both groups. However, cardiac structural adaptation in both groups revealed gender-related disparities. Female non-dippers were characterized by a higher left ve ntricular mass than female dippers (255 +/- 68 vs 184 +/- 81 g, p < 0, 05). Yet, no significant differences were found between male dippers a nd male non-dippers (234 +/- 48 vs 240 +/- 54 g). Further analyses wit h regard to relative and posterior wall thickness showed again no sign ificant differences between the two male groups. However, female non-d ippers were characterized by a higher relative wall thickness (0.45 +/ - 0.06 vs 0.39 +/- 0.06 mm, p < 0.05) and posterior wall thickness (1. 1 +/- 0.1 vs 0.89 +/- 0.2 mm, p < 0.05) than female dippers. Summing u p, dippers and non-dippers are hemodynamically characterized by a simi lar renal and systemic hemodynamic profile. However, development of le ft ventricular hypertrophy in female hypertensives is much more blood pressure-related than in male hypertensives.