Impact of blood pressure control on prevalence of left ventricular hypertrophy in treated hypertensive patients

Aim: The aim of the present study was to evaluate (1) the prevalence and pa tterns of left ventricular hypertrophy (LVH) and (2) the impact of blood pr essure (BP) control, assessed by clinical and 24-hour ambulatory BP monitor ing (ABPM) criteria on the persistence of LVH in a representative sample of treated patients attending our Hypertension Clinic. Methods: One hundred c onsecutive essential hypertensives (61 m/39 f, age 56 +/- 9 years) regularl y followed up by the same medical team (average period 52 months, 12-156 mo nths) were included in the study and underwent 24-hour ABPM and complete ec hocardiographic examination. Results: Twenty-eight of the 100 patients were found to have LVH [left ventricular mass index (LVMI) >125 g/m(2) in men a nd >110 g/m(2) in women]; LVH was eccentric in 20 patients and concentric i n the remaining 8. LVMI did not correlate with clinical BP values but only with ABPM values (mean 24 h systolic r = 0.34, p < 0.01; diastolic r = 0.37 , p < 0.01). The prevalence of LVH in patients controlled according to clin ical BP criteria (n = 43, BP <140/90 mm Hg) was 19%, in patients controlled according to ABPM criteria (n = 30, BP during daytime <132/85 mm Hg) 17%, and in those controlled with both criteria (n = 16) 6% (p <0.01). Conclusio ns; The results of this study suggest that the eccentric type of LVH is the prevalent pattern in chronically treated patients. The persistence of LVH is significantly dependent on BP levels achieved during treatment; indeed t he prevalence of LVH is very low in patients with an optimal BP control, wh ereas it is elevated (37%) in uncontrolled patients. Copyright (C) 2000 S. Karger AG, Basel.