The Relationship Between Blood Pressure Variability, Circadian Blood Pressure Rhythm, Blood Pressure Load And Left Ventricular Hypertrophy In Patients With Hypertension

Objective:To study the relationship between blood pressure variability, circadian blood pressure rhythm, blood pressure load and left ventricular hypertrophy (LVH) in patients with essential hypertension(EH). Methods: sixty-seven EH patients(38 males, 29 females,age 46~73 years, mean age 60.33 10.37 years), were divided into LVH group(21 males, 15 females, mean age 54.9 13.52 years) and non-LVH group(17 males, 14 females,mean age 61 + 11.43 years), and compared with age-matched normal controls(n=30,18 males, 12 females, age 42~68 years, mean age 54.87 + 9.94 years). CB ambulatory blood pressure monitor was employed to obtain average blood pressure, blood pressure variability,circadian blood pressure rhythm, and blood pressure load. Leftventricular mass index (LVMI) was evaluated by echocardiography. Results:(1)In LVH group,the average systolic blood pressure and diastolic blood pressure were obviously higher than those in non-LVH group; (2)The variability of systolic pressures was significantly higher than that of diastolic pressures in EH patients and normal controls. The variability of blood pressure during 24 hours is higher than that of daytime,which is higher than that of nighttime; (3)There were significantly difference in variability of systolic pressure between the three groups. The variability of diastolic pressure of daytime was obviously difference between LVH group and normal controls; (4) The systolic pressure load and diastolic pressure load was significantly difference between LVH group and non- LVH group, especially nocturnal blood pressure load(p<0.001) and 24 hours systolic pressure load(p<0.001); (5)There were significantly difference of the ratio of dipper between LVH group and non-LVH group, normal controls and non-LVH group. Conclusion: blood pressure variability,circadian blood pressure rhythm,blood pressure load are strongly relative to left ventricular hypertrophy in essential hypertension, and these index are important to predict and assess left ventricular hypertrophy.