title: Relationships between changes in left ventricular mass and in clinic and ambulatory blood pressure in response to antihypertensive therapy.
abstract: OBJECTIVE
  To analyse the relationships between changes in left ventricular mass in response to 6-month antihypertensive therapy and changes in conventional and automated measurements of clinic blood pressure, average 24 h ambulatory blood pressure and daytime and night-time blood pressures.
  
  
  METHODS
  After a placebo run-in period, patients with essential hypertension (World Health Organization stages I-II) were treated for 6 months with one or a combination of two first-line antihypertensive drugs.
  
  
  METHODS
  Investigations included echocardiography, conventional and automated clinic blood pressure measurements and ambulatory blood pressure monitoring. Daytime and night-time blood pressures were assessed according to two clock-time-dependent and two clock-time-independent methods, with a wide and a narrow approach for each technique.
  
  
  RESULTS
  Fifty-four patients completed the 6-month treatment period. Left ventricular mass, adjusted for sex and body size, was correlated significantly to systolic and diastolic clinic blood pressures, both before (r = 0.57 and r = 0.48, P < 0.001) and during antihypertensive therapy (r = 0.43, P < 0.001 and r = 0.27, P < 0.05). Changes in left ventricular mass were significantly related to changes in blood pressure. The correlation coefficients amounted to 0.39 (P < 0.01) and 0.40 (P < 0.01) for the conventional and automated measurements of clinic systolic blood pressures, respectively, and to 0.45 (P < 0.001) for the average 24 h systolic blood pressure; these r values were 0.27 (NS), 0.20 (NS) and 0.43 (P < 0.01), respectively, for the diastolic blood pressure. The average 24 h blood pressure added 7.4% (P < 0.05) and 6.2% (P = 0.06) to the variance of the changes in mass explained in terms of the conventional and the automated measurements of clinic systolic blood pressures, respectively, and 11.2% (P < 0.05) and 14.5% (P < 0.01) for the diastolic blood pressures. The changes in daytime and night-time blood pressures predicted the changes in left ventricular mass significantly (P < 0.01) and to a similar extent, irrespective of the analytical method.
  
  
  CONCLUSIONS
  The treatment-induced changes in left ventricular mass were significantly related to the changes in clinic, 24 h, daytime and night-time blood pressures; the changes in 24 h ambulatory blood pressure add to the variance of the changes in left ventricular mass explained in terms of clinic blood pressure data.
authors.affiliation: Department of Molecular and Cardiovascular Research, Faculty of Medicine, Catholic University of Leuven, Belgium.
authors.forename: R H
authors.initials: RH
authors.lastname: Fagard
authors.forename: J A
authors.initials: JA
authors.lastname: Staessen
authors.forename: L
authors.initials: L
authors.lastname: Thijs
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D004452:Echocardiography; D006321:Heart / Q000187:drug effects; D006352:Heart Ventricles; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D017275:Isradipine / Q000627:therapeutic use*; D017706:Lisinopril / Q000627:therapeutic use*; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009819:Office Visits
chemical_list: D000959:Antihypertensive Agents; D017706:Lisinopril; D017275:Isradipine