Not nondipping but nocturnal blood pressure predicts left ventricular hypertrophy in the essential hypertensive patients: the Korean Ambulatory Blood Pressure multicenter observational study.
J Hypertens
; 32(10): 1999-2004; discussion 2004, 2014 Oct.
Article
in En
| MEDLINE
| ID: mdl-25023153
ABSTRACT
OBJECTIVE:
The aim of this study was to investigate whether nocturnal blood pressure (BP), established on the basis of a single 24-h BP monitoring, is a stronger predictor of left ventricular hypertrophy (LVH) compared with nondipping status in the essential hypertensive patients.METHODS:
A total of 682 hypertensive patients (mean age 56.1â±â14.5 years, 50.7% women) who underwent echocardiography were enrolled. 'Nondipping status' was defined as a nocturnal SBP fall less than 10% of daytime mean SBP. LVH was defined as a left ventricular mass index exceeding 54.0âg/m in men and 53.0âg/m in women. Each patient was categorized in three groups according to the total cardiovascular risk using 2007 European Society of Hypertension/ European Society of Cardiology guidelines as average or low, moderate, and high or very high added risk.RESULTS:
Among 682 participants, 184 (26.9%) showed LVH on echocardiography. The proportion of individuals with high or very high added cardiovascular risk profile was 356 (52.1%). In multiple logistic regression analysis, age 56 years at least [odds ratio (OR) 1.047, 95% confidence interval (CI) 1.031-1.063, Pâ<â0.0001], female participants (OR 1.751, 95% CI 1.172-2.616, Pâ=â0.0062), BMI higher than 24.6âkg/m (OR 1.178, 95% CI 1.110-1.250, Pâ<â0.0001), smoking (OR 1.793, 95% CI 1.028-3.127, Pâ=â0.0397), and nocturnal SBP at least 127âmmHg (OR 1.032, 95% CI 1.009-1.055, Pâ=â0.0059) were significant independent predictors for LVH whereas nondipping was not (OR 0.857, 95% CI 0.481-1.528, Pâ=â0.6013).CONCLUSION:
These findings suggest that nocturnal BP rather than nondipping may be a better predictor of LVH, especially in secondary or tertiary referral hospital setting targeting relatively high cardiovascular risk patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Circadian Rhythm
/
Hypertrophy, Left Ventricular
/
Hypertension
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Hypertens
Year:
2014
Document type:
Article