Jm. Pascual et al., Out patient blood pressure and left ventricular hypertrophy in untreated hypertensive patients, MED CLIN, 112(5), 1999, pp. 166-170
BACKGROUND: The study was designed to evaluate blood pressure (BP) values r
elated to left ventricular hypertrophy (LVH) in a group of never treated mi
ddle-aged hypertensive subjects.
PATIENTS AND METHOD: Non-invasive ambulatory blood pressure monitoring (ABP
M) and echocardiography were performed in 149 hypertensive patients (25-50
years-old) with diastolic blood pressure (DBP) 90-114 mmHg. LVH was conside
red when left ventricular mass (LVM) was > 134 g/m(2) in males and > 110 g/
m(2) in females.
RESULTS: 43% of patients had LVH. Patients with LVH had higher clinic and a
mbulatory BP values. The greatest diferences were in mean 24 h SBP (p = 0.0
01) and in 24 h DBP (p = 0.006). With respect to LVH, there were no differe
nces between dippers and non-dippers, males or females, and circadian or BP
variability. LVM was positively correlated with clinical DBP (p = 0.24), 2
4 h SEP (p = 0.41), pulse pressure (PP) (p = 0.36) and absolute BP variabil
ity (p = 0.23), Multiple regression analysis confirmed that 24 h SEP and se
x where positively associated with LVH independent of others factors. The e
xistence of 24 h SEP > 150 mmHg dramatically increased the risk of LVH (odd
s ratio [OR] = 9.2; CI 95%: 2.8-29.3; p = 0.002).
CONCLUSIONS: The present study indicates that in never treated middle-aged
essential hypertensive patients the principal factor related to the presenc
e of LVH is the value of systolic blood pressure throughout a 24 h period.