ABSTRACT
The relationship between blood pressure load, the specific LV Geometric patterns and urinary albumin excretion remains rather unclear. To evaluate such relation; this study was conducted to evaluate the relationships among left ventricular geometric patterns abnormality and urinary albumin excretion in elderly patients with hypertension and electrocardiographic [ECG] documented LV hypertrophy. In 143 patients with hypertension, 24 h. Ambulatory blood pressure monitoring, single urine albumin determination, and echocardiography were performed after 14 days of stopping all medications, to be maintained only on a life style modification regimen. The cases were grouped according to the left ventricular geometric patterns into: normal, concentric remodelling, concentric hypertrophy and eccentric hypertrophy [the number of cases was; 24, 17, 28 and 63 respectively]. Also were grouped according to urinary albumin excretion into; normal albuminuric, micro and macro- albuminuric [the number of cases was; 78, 26 and 6 respectively]. Ambulatory BP, but not office BP, was higher among albuminuric compared to normal-albuminuric patients. In patients with established hypertension, day-time pulse pressure and office BP were different in the four LV geometric patterns, with the highest pressure in those with abnormal geometry. Furthermore, micro-albuminuria was more frequent in hypertensive patients with LV hypertrophy than in those with either normal geometry or concentric remodelling. White coat hypertensive [10%] showed lower LVMI and no micro-albuminuria compared to patients with established hypertension. There were no differences in the prevalence of nondippers among the four LV geometric patterns or in micro-albuminuria. In conclusion, increased office BP and day-time pulse pressure and were associated with an increased prevalence of an abnormal LV geometry. Micro-albuminuria was more frequent in groups with concentric and eccentric LV hypertrophy. Ambulatory BP, but not office BP was higher in albuminuric than normo-albuminuric patients. In patients with micro-albuminuria; 24- h Ambulatory BP did not provide an additional information beyond office BP