To evolve simple BP measurement steps and limited echocardiography to detect pre and masked hypertension and and cardiac end organ damage.Design and Method:
We retrospectively examined 9500 echocardiography exam from April 2014 to Dec 2025. Echo is performed as per guidelines of American Society of Echocardiography. In addition, we routinely measure BP at begining, at 5 minutes during and at end of echo exam. Values are averaged. After excluding valvular heart diseases, HOCM, infiltrative diseases, CAD with regional changes, we had 8471 eligible cases for review. Patients were divided in 3 groups. A-Systolic BP less than 130 (Normotensive), B- Systolic BP 130- 139 (Pre- hypertensive), C-Systolic BP more than 139 (Hypertensive). No treatment history was available.Results:
The male, female ratio was 1.3. Average age 55+/-15 yrs. Average BMI 26.6+/-4%. Average HR, LV ejection fractionwas similar in all 3 groups. The change in BP was significant between 3 groups. The variation between 1st, 2nd and 3rd reading was statistically significant. In gr A variability was 5.0 and 6.8 mmHg in males and females. compared to 8.9 and 8.5 mmHg respectively in group B and C (p value less than 0.00001). All echo parameters were statistically significantly higher in Gr B and C than Gr A.(p less than 0.0001). Rise in BP from 2nd to 3rd reading was statistically significant in group B (Pre hypertensives) than gr A (normotensives). Sequential fall of BP is seen in Group A (Normotensive) compared to Groups B & C which showed variability (p < 0.0001).Conclusions:
It is concluded that simple 3 step sequential BP measurements 5 minutes apart, and variability can identify pre- and masked hypertensives, in lieu of ABPM. Suitable for mass screening for Hypertension. A limited single parameter echo exam provides incremental value in unmasking HTN and cardiac end organ damage. Threshold to consider a patient hypertensive needs review.