Role of Ambulatory Blood Pressure monitoring in evaluating hypertensive patients with and without left ventricular hypertrophy

ABSTRACT

This study included 60 patients with essential hypertension [32 females and 28 males], their age ranged from 43 to 59 years [mean 52 +/- 4 Twenty normal, age and sex matched, healthy subjects were also studied as a control group. All subjects were subjected to 24 hours Ambulatory Blood Pressure Monitoring [ABPM], EGG and Echocardiography. According to echocardiographic parameters, hypertensive patients were classified into two groups. hypertensives with left ventricular hypertrophy [LVH] and hypertensives without LVH. This study revealed Significant increase in left ventricular mass and LVH in hypertensive versus normotensive group. LVH is more closely related to ambulatory blood pressure than to casual blood pressure. Closer relation of systolic over diastolic BP to the degree of hypertrophy, another evidence that wall stress which is mostly related to systolic blood pressure [SBP] is a key factor influencing LVH development. Significant increase in left ventricular mass and LVH in hypertensives with marked fluctuation in BP throughout 24 hours versus hypertensives without marked fluctuations. Significant increase in LVM in hypertensive non-dippers versus hypertensive dippers. The propensity for LVH among patients with hypertension is increased with age and with the duration of hypertension. The results of this study shows a significant relationship between cir-cadian blood pressure changes and left ventricular hypertrophy which underlines the importance of ambulatory blood pressure monitoring in evaluating the effects of hypertension in relation to left ventricular hypertrophy