The prognostic value of ambulatory blood pressure monitoring in untreated mild-to-moderate hypertensive patients: correlation with echocardiography.
BACKGROUND
Target organ damage by hypertension should be related to the daily duration of blood pressure elevation.


METHODS
Thirty-six previously untreated patients with mild to moderate hypertension were examined by 2-D, M-mode, Doppler echocardiography and with 24-hour ambulatory blood pressure monitoring. The resulting parameters were compared with those of normotensive subjects. Elevated BP values during the waking hours (> 125/85 mmHg) and sleeping hours (> 115/80 mmHg) were used to calculate the total percentage of abnormal BP values (load) in each patients.


RESULTS
In patients with hypertension, left atrial index and left ventricular mass index were significantly greater than those of normotensive subjects (21 +/- 4 vs 18 +/- 3 mm/m2, p < 0.05; 127 +/- 25 vs 94 +/- 19 gm/m2, p < 0.01). Doppler measurement of diastolic filling velocity was significantly different between the two groups, with an early LV filling velocity lower (38 +/- 11 vs 45 +/- 10 cm/sec, p < 0.05) and a late LV filling velocity higher (50 +/- 9 vs 45 +/- 12 cm/sec, p < 0.05) in the hypertensives. Casual systolic and diastolic BP values did not correlate with cardiac structural and functional variables. There were significantly inverse correlations between both sleeping diastolic blood pressure and sleeping DBP load and fractional shortening (r = -0.39, p < 0.05; r = -0.43, p < 0.01, respectively).


CONCLUSIONS
These data showed that the majority of patients with hypertension have either cardiac structural or functional abnormalities, or both. High nocturnal diastolic blood pressure and DBP load may have a more determinant effect on systolic function in mild to moderate hypertensive patients.
Pai
P Y
PY
Department of Internal Medicine, China Medical College Hospital, Taichung, Taiwan.
Chou
H T
HT
Tsou
S S
SS
Wang
T F
TF
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis