The Correlation Between Ambulatory Blood Pressure And Left Ventricular Hypertrophy In Hypertensive Patients

Objective: To explore the relationship between ambulatory blood pressure(ABP)blood pressure levels, blood pressure variability(BPV) and left ventricular hypertrophy(LVH) in hypertensive patients.Methods: 285 essential hypertensive patients(57.9% men; 53.83±12.91 years)were selected from October 2011 to January 2014 in the Department of Cardiovascular Diseases of Fujian Provincial Hospital. All of the subjects were divided in two groups based on left ventricular mass index(LVMI)(LVMI≥115( male),≥95g/ ㎡( female)): LVH group(male: 139.97±24.34, female:115.18±19.34,44.1% male) and no LVH group(male: 85.56±15.17, female:74.48±11.88, 62.2% male).Ambulatory blood pressure, anthropometric measurements,biochemical indicators and echocardiographic indices were recorded. Data were analyzed with SPSS 19.0. P < 0.05 was considered statistically significant.Results:(1)Age and glycohemoglobin was significantly higher in patients with LVH compared with those without LVH(60.07±11.00 vs. 51.87±12.87,P=0.000; 6.05±0.65 vs. 5.839±0.54,P=0.008),respectively. Higher LVMI group has significantly variability in sex( femal,55.9% vs. 37.8%,P=0.008). There were no significant difference in body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol,fasting blood gluose, insulin,insulin resistance index and insulin sensitivity(P>0.05).(2)Night-time systolic blood pressure average was significantly higher in patients with LVH compared with those without LVH(126.32±14.32 vs 125.30±13.46,P<0.049).The extent of nocturnal SBP decline was related to LVMI(2.85±8.23 vs 5.25±7.21,P=0.021). There were no significant difference in 24 h SBP, 24 h DBP, d SBP, d DBP,n DBP, SD(PS), SD(PD), CV(PD) and CV(PS)(P>0.05).(3)Left ventricular septal wall thickness diameter was significantly higher in patients with 24 h SBP > 130 mm Hg compared with those 24 h SBP normal(1.125±0.188 vs1.072±0.164,P=0.028). There were no significant difference in PWTd, LV and LVMI(P>0.05).(4)Plasma renin activity was significantly lower in patients with LVH compared with those without LVH( 0.474±0.489 vs 0.822±0.800, P < 0.05). There were no significant difference in Ang II, Ang I, ALD and Cor(P>0.05).(5)LVMI was significantly associated with night blood pressure, Hb A1 c and nocturnal blood pressure fall(r=0.136,P=0.022 or r=0.161,P=0.006 or r=-0.123,P=0.039),respectively. SWTd was significantly associated with 24 h SBP(r=0.234,P=0.000).Conclusions: The presence of LVH in essential hypertension was associated with higher mean ambulatory night-time systolic BP and lower plasma renin activity. The patients of higher 24 h SBP was associate with higher left ventricular septal wall thickness diameter.