| Measurements of ambulatory blood pressure as an adjunct to casual/clinic blood pressure measurements are widely used for the diagnosis and treatment of hypertension currently. It has uniformly demonstrated on a cross-sectional basis that average ambulatory blood pressure (ABP) is correlated to target-organ damage. Several event-based cohort studies have shown that ABP improves cardiovascular risk stratification over and beyond office BP. Most of these studies have been conducted in subjects with essential hypertension (EH) who were treated at the time of execution of ABP monitoring; other studies have beenconducted in subjects who were poorly controlled with treatment or in untreated hypertension patients. But few studies conducted in patients with non-diabetic EH, while Diabetes Mellitus is the most important risk factor of end-target damage and cardiovascular events.ObjectivesThe objective of this study was to establish whether ambulatory blood pressure offered a better estimate of cardiovascular risk than its clinical blood pressure counterpart did in non-diabetic untreated essential hypertension subjects.Objects and Methods1. Patients and controls82 untreated EH patients were included in the study. (43 male, 39 female, the mean age was 63 + 10 years and the mean history time was 7.98 7.94 years)The inclusion criteria were as following: clinical diastolic BP was above 90 mmHg and (or) systolic BP was above 160mmHg.Exclusion criteria were as following: patients with diabetes mellitus or secondary hypertension; patients had a history or sign of previous cardiovascular events, such as congestive heart failure, myocardial infarction, angina pectoris and stroke; patients had renal diseases, urine tract diseases and serum creatinine level above 1.5mmol/L; conditions preventing from data collection, such as atrial fibrillation and pulmonary emphysema.All the patients were first divided into two groups according to clinical blood pressure level. 26 Patients in group 1: BP below 140/90 mmHg. And 56 patients in group 2: BP level above 140/90mmHg. All the patients were then divided into another two groups according ABPM monitoring, 27 patients in group A : mean blood pressure below 130/85mmHg,and 55 patients in group B : mean blood pressure above 130/85mmHg. 2. Methods2.1 BP was measured in a quiet environment with a mercury sphygmomanometer with the patient in a supine position after 10 minutes' rest, SBP and DBP (Korotkoff phase I and phase V, respectively) represented in each visit the mean of three different readings measured at 2-minute intervals.2.2 ABPM was performed with the use of an oscillometric monitor(Spacelabs 9200 ), recording began between 8:30 and 9:00 with readings every 30 minutes to 8:00 in the next morning. Recording mean systolic blood pressure(MSBP) mean diastolic blood pressure (MDBP) pulse pressure (PP=MSBP-MDBP), daytime mean systolic blood pressure (dSBP), daytime mean diastolic blood pressure(dDBP), night mean systolic blood pressure(nSBP), night mean diastolic blood pressure (nDBP).2.3 Blood samples were obtained in the morning after a minimum of 8 hours fasting. Serum biochemical profiles were measured using an autoanalyzer system multianalyzer computer: creatinine, cholesterol and glucose.Two separate 24-hour urine collections were measured using an immunonephelometric assay (BECKMAN ARRAY) to measure micro-albuminuria.2.4 EchocardiographyEchocardiography were performed with SONOS-5500 Doppler Echocardiography instrument, left ventricle internal dimensions (LVIDd), posterior wall (LPWP) and interventricular septum thickness (IVST) were measured according to the recommendations of American Society of Echocardiography. Left ventricular mass (LVM) and Left ventricular mass index (LVMI) were calculated by the formula as following '?LVM(g)=0.8 X1.04[(IVST+LVIDd+LPWP)3-LVIDd3]+0.6, LVMI (g/m2) =LVM/BSA2.5 Intima media thickness (IMT) and plaque of the carotid arteryThe...
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