Circadian rhythm of arterial pressure and state of target-organs in patients with mild and moderate hypertension

Aim. To assess the state of target-organs in finales with mild and moderate forms of essential hypertension (Ell) in normal and disturbed 24-h rhythm of arterial pressure (AP). Material and methods. Target-organs were examined in 70 males aged 30-62 ye ars (mean age 49 +/- 1 years) with mild (n = 54) or moderate (n = 16) EH. T he following tests were performed: ophthalmoscopy, echo-CG with estimation of the left-ventricular myocardial mass index (LVMMI), duplex scanning of t he carotid arteries (DS), AP monitoring, measurements of plasma creatinine, relative density of the urine, glomerular filtration rate, examination of the neurological status. Circadian rhythm of AP it-as evaluated by a nightf all (NF) of systolic pressure (SP). Patients with inadequate NF of SP (< 10 %) entered group 1, those with normal NF of SP (10% < NF SP < 20%) were all ocated to group 2. Results. Patients of group I had a significantly higher LVMMI, more frequen t occurrence of left ventricular hypertrophy and carotid artery affection ( local thickening 'intima-media'). In group 1 there was also a complex of un favourable changes in AP circadian: profile, especially at night. Conclusion. Mild/moderate EH with insufficient NF of SP is associated with more pronounced and frequent changes in the target-organs (left-ventricular hypertrophy, "intima-media" thickeing). Insufficient NF of AP initiates hi gher pressor load on the target-organs, on the one side, and reflects defec tive regulation which affects target-organs, on the other. Both these facto rs contribute to damage of the target-organs.