To examine the relationship between central and ambulatory blood pressure (BP) parameters and echocardiographic or electrocardiographic left ventricular hypertrophy (LVH) in hypertensive patients.Design and method:
This study analyzed 670 hypertensive patients from the Korean registry of target organ damages in hypertension (age 49 ± 12 years; 62.5% male). Left ventricular (LV) mass indexed to body surface area (BSA) was used to detect echocardiographic LVH – threshold values of 95 and 115 g/m2 for women and men. Electrocardiographic LVH was determined using the Sokolow-Lyon index and Cornell product.Results:
Echocardiographic and electrocardiographic LVH was found in 19.7% and 20.5% of the patients, respectively. Daytime systolic BP and nighttime diastolic BP among ambulatory BP parameters and central BPs had significant correlations (Pearson r = 0.137, p = 0.032 for daytime systolic BP; r = 0.164, p = 0.01 for nighttime diastolic BP; r = 0.184, p = 0.003 for central systolic BP; r = 0.174, p = 0.005 for central diastolic BP). The patients with echocardiographic LVH were older; had higher values for pulsed wave velocity, central BPs and augmentation index. Older patients and higher ambulatory BPs and central BPs were associated with electrocardiographic LVH. In logistic regression analysis of echocardiographic LVH, the association of age (odds ratio [OR] 1.039, 95% confidence interval [CI] 1.011–1.067) and central systolic BP (OR 1.03, 95% CI 1.013–1.047) with echocardiographic LVH remained significant. In the multivariate analysis of electrocardiographic LVH, daytime systolic BP were independently significant (OR 1.03, 95% CI 1.012–1.048).Conclusions:
Central systolic BP and old age were related to the presence of echocardiographic LVH. On the other hand, daytime systolic BP was associated with electrocardiographic LVH. This finding suggests that implication of each BP parameter is different in terms of investigating high risk hypertensive patients.