고혈압 환자에서 24 시간 활동 혈압과 좌심실비대와의 상관관계에 대한 연구

• Published in: The Korean journal of medicine Vol. 45; no. 1; pp. 38 - 44
• Main Authors: 김상욱, Sang Wook Kim, 유재격, Jae Kyuk Rhoo, 김현대, Hyun Dae Kim, 이은우, Eun Woo Lee, 이성윤, Sung Yun Lee, 박승호, Seung Ho Park, 류왕성, Wang Seong Ryu, 유언호, Un Ho Ryoo
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.07.1993
• Subjects: Ambulatory blood pressure; Left ventricular hypertrophy
• ISSN: 1738-9364

Background: 24-hour noninvasive ambulatory blood pressure monitoring (ABPM) has been shown to be superior to casual BP in predicting target organ involvement in patients with hypertension and assessing anti-hypertensive therapy. This study was done to examine the relation of BP decline from day to night to the echocardiographic parameters of left ventricular anatomy in unselected hypertensive patients and normotensive subjects undergoing 24-hour noninvasive ABPM. Methods: The effect of variation of blood pressure on the echocardiographic parameters of left ventricular hypertrophy were investigated in 71 consecutive subjects. (47 patients with essential hypertension and 24 healthy normotensive subjects). 24-hour noninvasive ambulatory blood pressure monitoring and cross-sectional and M-mode echocardiography were done to examine the relation between ABPM and echocardiographic LVH. Results: 24-hour ambulatory blood pressure was lower than casual blood pressure, and weak relation was noted particularly in patients with mild-to-moderate hypertension. The continuous monitoring of BP throughout day shows characteristic circadian pattern. The highest BP was recorded at 10 am and lowest value was at 2 am-4 am. Ambulatory daytime blood pressure (6 am-8pm) was higher 15% than night-time blood pressure (8 pm-6 am), The correlation coefficient of daytime systolic blood pressure was r=0.42 (p<0.01), twenty-four hours systolic BP was r=0.41 (p<0.05). The daytime and 24 hours systolic BP seems to be more closely related to LVH than night-time BP, but the correlation was not high enough in our study. Conclusion: 24-hour ambulatory blood pressure monitoring is more useful than casual BP in patients with hypertension, and LVH in echocardiography is more closely related to daytime and 24 hours systolic BP than night-time BP.