LEFT-VENTRICULAR MASS IS BETTER CORRELATED WITH ARISING BLOOD-PRESSURE THAN WITH OFFICE OR OCCASIONAL BLOOD-PRESSURE

The peak incidence of cardiovascular complications in the morning poin ts to a possible role of the abrupt increase in blood pressure on aris ing. However, there is as yet no firm evidence linking the extent of t he elevation in blood pressure on arising and the risk of cardiovascul ar complications. We sought a correlation between blood pressure on ar ising and left ventricular mass in a population of 181 previously untr eated hypertensive patients. Ambulatory blood pressure was measured:ov er a 24-h period, and each patient was requested to trigger a blood pr essure determination immediately after standing on arising in the morn ing. Left ventricular mass was measured with M-mode echocardiography a nd indexed for height, height(2.7), and body surface area. The systoli c blood pressure on arising was significantly (P <.01) better correlat ed than office blood pressure with left ventricular mass index and wal l thickness. On multivariate analysis, the values of systolic blood pr essure on arising and mean 24-h systolic blood pressure contributed si gnificantly and independently to the correlation with left ventricular mass and wall thickness. These observations point to the significance of the arising blood pressure. A marked abrupt daily elevation in blo od pressure on arising, then maintained for a certain time, could cont ribute to the development of left ventricular hypertrophy and may cons titute a trigger for cardiovascular complications. (C) 1997 American J ournal of Hypertension, Ltd.