Characteristic abnormal findings of ambulatory blood pressure indicative of hypertensive target organ complications

• Published in: European heart journal Vol. 15; no. 8; p. 1037
• Main Authors: Tseng, Y Z, Tseng, C D, Lo, H M, Chiang, F T, Hsu, K L
• Format: Journal Article
• Language: English
• Published: England 01.08.1994
• Subjects: Adult; Aged; Blood Pressure Monitors; Circadian Rhythm - physiology; Electrocardiography; Female; Humans; Hypertension - complications; Hypertension - physiopathology; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Male; Middle Aged; Proteinuria - etiology; Proteinuria - physiopathology; Retinal Diseases - etiology; Retinal Diseases - physiopathology; Risk Factors; Ventricular Function, Left - physiology
• ISSN: 0195-668X
• DOI: 10.1093/oxfordjournals.eurheartj.a060625

To study the correlation between ambulatory blood pressure and target organ complications of hypertension, ambulatory blood pressure monitoring was performed on 290 patients with mild to moderate essential hypertension before treatment. Their target organ complications of hypertension were assessed by ECG, chest X-ray, urinalysis and an eye-fundus examination. An average ambulatory diastolic blood pressure value greater than the casual diastolic blood pressure was found in 35% of subjects with ECG evidence of left ventricular hypertrophy (LVH) and 5.2% of subjects without (P < 0.001); in 36.5% of patients with chest roentgenographic evidence of LVH and 8.4% of patients without (P < 0.0001); in 38.5% of patients with proteinuria and 11% of patients without (P < 0.0001); and in 27.1% of subjects with retinopathy and 10.7% of subjects without (P < 0.01). A similar result was observed for the systolic blood pressure. A reversed circadian pattern of ambulatory diastolic blood pressure was observed in 32.5% of patients with ECG evidence of LVH and 12.9% without (P < 0.0001); in 28.8% of patients with chest roentgenographic evidence of LVH and 16% without (P < 0.05); in 26.9% of subjects with proteinuria and 17.4% without (P < 0.05); in 37.5% of patients with retinopathy and 14.5% without (P < 0.0001). A similar result was also demonstrated for ambulatory systolic blood pressure. There was a close relationship between the blood pressure load and hypertensive target organ complications in terms of LVH and proteinuria, and between significant nocturnal reduction of ambulatory systolic blood pressure and LVH.