RELATIONSHIPS BETWEEN AMBULATORY BLOOD-PRESSURE, FOREARM VASCULAR-RESISTANCE, AND LEFT-VENTRICULAR MASS IN HYPERTENSIVE AND NORMOTENSIVE SUBJECTS

Ambulant 24 h blood pressure was recorded in 97 untreated hypertensive subjects (50 with, 47 without echocardiographic signs of left ventric ular hypertrophy) and 45 matched normotensive subjects. Forearm vascul ar resistance was calculated from mean blood pressure and blood flow, which was measured by venous plethysmography during reactive hyperemia . Blood pressure variability was calculated by standard deviations of pressure values. Systolic 24 h blood pressure exhibited the closest co rrelation with left ventricular mass index in hypertensives (4 = 0.48; P < .001). No relation could be found between blood pressure fall dur ing the night and left ventricular mass index. Furthermore, body weigh t was a significant correlate of left ventricular mass (r = 0.53; P < .001). Regression analysis indicated that body weight and 24 h blood p ressure were the principal determinants of left ventricular mass. Bloo d pressure variability was significantly higher in hypertensive than i n normotensive subjects (P < .05). The highest vascular resistance was found in hypertensive patients with left ventricular hypertrophy comp ared with the other groups (P < .05). A significant close correlation between systolic resting as well as 24 h blood pressure and vascular r esistance was identified for the group of hypertensives and all subjec ts investigated. Furthermore, left ventricular mass index and vascular resistance were correlated (in hypertensives: r = 0.32; P < .01). The extent of left ventricular mass index and forearm vascular resistance are proportional to the severity of hypertension. As vascular resista nce and left ventricular mass are also related, these findings could s peak for a parallel development of total peripheral resistance and lef t ventricular hypertrophy in essential hypertension.