Document Detail

Left ventricular geometry, ambulatory blood pressure and extra-cardiac organ damage in untreated essential hypertension.
MedLine Citation:
PMID:  20305545     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: Limited information is available on the association between left ventricular (LV) geometric patterns defined according to updated criteria and blood pressure (BP) levels and extra-cardiac organ damage (OD) in human hypertension. Thus, in untreated essential hypertensives we assessed the relationship between LV geometry, ambulatory BP and markers of vascular and renal OD. METHODS: A total of 669 hypertensives were categorized in four groups according to LV geometric patterns defined by two sets of sex-specific criteria (i.e. LV mass indexed to body surface area and height) and by the relative wall thickness (RWT) partition value of 0.42. Ambulatory BP variables were derived from two 24-h monitoring sessions performed within 4 weeks. RESULTS: Lower clinic and ambulatory BP values were associated with normal LV geometry, intermediate values with either LV concentric remodelling or eccentric LV hypertrophy (LVH) and higher values with concentric LVH, regardless of the criteria used to categorize these cardiac phenotypes. A decrease in nocturnal BP dip occurred from normal LV geometry to concentric LVH and this was associated with a parallel increase in the prevalence of carotid and renal OD, which was highest in concentric LVH. In a multivariate analysis age (beta=0.204, P<0.0001), followed by LDL cholesterol (beta=0.113, P=0.004), and night-time BP (beta=0.101, P=0.009) turned out to be the best independent correlates of RWT. CONCLUSION: These findings indicate that LV geometric patterns, regardless of categorization criteria, reflect different degrees of BP load and subclinical extra-cardiac alterations and may be regarded, in addition to absolute values of LV mass, as a reliable marker of cardiovascular (CV) risk.
Cesare Cuspidi; Valentina Giudici; Francesca Negri; Carla Sala; Giuseppe Mancia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  15     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  124-31     Citation Subset:  IM    
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy.
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MeSH Terms
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory*
Carotid Arteries / pathology
Circadian Rhythm
Hypertension / complications*,  pathology*
Hypertrophy, Left Ventricular / complications*,  pathology*
Middle Aged
Tunica Intima / pathology
Ventricular Remodeling

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