ABSTRACT
The aim of the study is to evaluate daytime blood pressure variability in hypertensive patients and to quantify its relation to left ventricular hypertrophy. Design: Observation study conducted between August 2001 and June 2002. Setting: Non-invasive cardiac laboratory, Medicine Department, Farwania Hospital. 100 patients were included in the study. All patients were referred from out-patient clinic in Farwania Hospital with blood pressure more than 140/90 mm Hg. Resting ECG and echocardiography were done to assess left ventricular hypertrophy [LVH]. Exercise ECG test was done to exclude patients with ischaemic heart disease. Ambulatory blood pressure was recorded with an auscultatory device to study blood pressure variability [BPV]. The patients were classified into two groups: Group I included 60 patients with left ventricular hypertrophy and Group II included 40 patients without left ventricular hypertrophy. There was a significant increase in age, serum cholesterol, LVMI and LV diastolic dysfunction [P<0.05], maximum systolic blood pressure and daytime systolic blood pressure load [P<0.05] in patients of Group I than those of Group II. There was a significant increase in, daytime systolic blood pressure [p<0.01], pulse pressure [P<0.05] and the mean blood pressure variability [P<0.05] in hypertensive patients with LVH than those without LVH. Correlation between daytime systolic BPvariability and LVH [p<0.05] was also significant. Stepwise logistic multivariate analysis revealed a significant relation with age [P<0.05], hypercholesterolemia [P<0.01], maximum SBP [P<0.05], daytime SBP load [P<0.01] and daytime SBP variability. There were significant increases in age, LVMI, maximum SBP, and daytime SBP load [P<0.05] in the fourth quintile of daytime SBP variability. There was a significant relation between blood pressure variability and left ventricular hypertrophy. This variability increased with age, hypercholesterolemia and increased BP load