Impacts of ambulatory pulse pressure and office pulse pressure on left ventricular hypertrophy in patients with essential hypertension

50A

POSTERS: Blood Pressure Measurement/Monitoring

AJH–May 2004 –VOL. 17, NO. 5, PART 2

a better blood pressure control. However, this treatment did not change their diurnal blood pressure pattern.

than non-LVH group (49.4⫾10.1 mmHg vs. 44.1⫾9.0 mmHg, P⬍0.001 and 133.0⫾12.9 mmHg vs. 126.2⫾12.8 mmHg, P⬍0.001). PP rose progressively with aging, and after 60 years, the rate accelerated steeply. In middle-aged and senile subjects, the increase in PP was primarily due to large-artery elasticity deterioration. And it was the important determinant of LVH.

Key Words: Nondipping, Hypertension and Diabetes Mellitus, AT1 Antagonist

P-49 IMPACTS OF AMBULATORY PULSE PRESSURE AND OFFICE PULSE PRESSURE ON LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH ESSENTIAL HYPERTENSION Lisong Liu, Qi Hua, Jian Zhang. Department of Cardiology, Beijing Xuanwu Hospital, Beijing, Beijing, China. To evaluate the impacts of ambulatory pulse pressure(PP) and office PP on left ventricular hypertrophy(LVH) in patients with essential hypertension. Totally 337 initially untreated subjects with mild to moderate essential hypertension (age 51.9⫾8.8, 43.6% men)were included in this study. All subjects took 3 times blood pressure measurements in different days, ambulatory blood pressure monitoring and echocardiography. 1 Subjects were divided into four groups according to their ambulatory pulse pressure levels and into five groups according to their office PP levels. Compare the results respectively. 2 They were further divided into LVH and non-LVH group according to the degree of left ventricular mass index(LVMI). Both ambulatory PP and office PP were significantly correlated with age, history of hypertension, LVMI, arterial stiffness index and 24-hour heart rate. Arterial stiffness evolved progressively with PP increase, and it correlated with ambulatory PP much more significant than office PP(r⫽0.670, p⬍0.01 vs. r⫽0.399, p⬍0.01). Ambulatory PP and 24-hour systolic blood pressure(SBP) were significantly higher in LVH group than non-LVH group [(49.0⫾10.2) mmHg vs. (44.7⫾8.9) mmHg, p⬍0.001 and (132.1⫾13.1) mmHg vs. (126.5⫾12.7) mmHg, p⬍0.001]]; Ambulatory PP was associated with LVMI much stronger than office PP(r⫽0.277, p⬍0.01 vs. r⫽0.105, p⬍0.05). The increase of PP was an important determinant of LVH. Compared with office PP, ambulatory PP provided a more precise estimate of target organ damage upon hypertensives. Key Words: Hypertension, Pulse Pressure, Hypertrophy

P-50 RELATIONSHIP OF AGE, LEFT VENTRICULAR HYPERTROPHY AND 24-HOUR MEAN PULSE PRESSURE IN PATIENTS WITH ESSENTIAL HYPERTENSION Lisong Liu, Qi Hua, Jian Zhang, Beilei Pang. Department of Cardiology, Beijing Xuanwu Hospital, Beijing, Beijing, China. The study is to investigate the relationship between age, left ventricular hypertrophy(LVH) and 24-hour mean pulse pressure(PP) in patients with essential hypertension. 433 initially untreated subjects with mild to moderate essential hypertension were involved in this study. All subjects underwent 24-hour ambulatory blood pressure monitoring and echocardiography. They were divided into four groups according to their 24-hour mean PP scale, and were divided into LVH and non-LVH group according to their left ventricular mass index (LVMI) level. Patients were further divided into three age groups, group I: 40ⱕage⬍50; group II: 50ⱕage⬍60; group III: ageⱖ60, respectively. 24-hour mean PP were significantly correlated with age (r⫽0.466, P⬍0.01), arterial stiffness index (r⫽0.681, P⬍0.01), LVMI (r⫽0.279, P⬍0.01), and 24-hour heart rate (r⫽⫺0.142, P⬍0.01). Hypertensive subjects showed a progressive increase in 24-hour mean PP earlier, and the rate of rise accelerated after age 60 years. Both 24-hour mean PP and 24-hour systolic blood pressure were significantly higher in LVH group

Key Words: Pulse Pressure, Hypertrophy, Hypertension

P-51 THE LISINOPRIL EFFECTS UPON BLOOD PRESSURE DIURNAL RHYTHM AND[ LEFT VENTRICULAR MYOCARDIAL MASS IN ESSENTIAL HYPERTENSION Elena G Kupchinskaya, Elena V Bobrova, Larissa V Bezrodna, Irina V Lizogub. Hypertension, Institute of Cardiology, Kyiv, Ukraine. Objective: to study the arterial blood pressure (BP) level, left ventricular (LV) hyper- trophy and LV function dynamics in essential hypertension (EH) patients (pts) during long term angiotensin converting enzyme inhibition lisinopril (L) monotherapy ( M). Methods: we investigated 23 EH pts, which were divided into two group: 1-st with “dipper” BP diurnal rhythm type (BPDRT) (n⫽14 pts), 2-nd – “non-dipper” BPDRT (n⫽9). The BP level was studied by 24-hour ambulatory BP monitoring (ABPM), LV hypertrophy and LV function (LVF) – by echocardiography M-mode and B-mode regiments. Before L treatment the diurnal “dipper” BP type was in 14 EH pts, “non-dipper” type – in 9 EH pts. The LV myocardial mass index (LVMMI) was more than 125 gr/m2 in13 pts, 10 pts had it less than 125 gr/m2. The examination was made before and after LM in dosage 10 –20 mg daily during 6 –7 mouths. Result: the LVMMI decreasing on 10 mg/m2 and more during LM treatment were in 9 pts (all of them have LVH initial, others – LVMMI during investigate time don’t signification change). The LVMMI decrease was calling by LV posterior wall thickness (PWT), interventricular septum thickness (IVST) and LV end-diastolic diameter (EDD) decrease. The PWT, IVST and EDD dynamics were depend from LV remodelling type in certain measure. We observed the velocity of circumferential fiber shortening (Vcf) increase in all groups from (1,16⫾0,08 to 1,28⫾0,08)sec⫺1 in with LVMMI decrea sing and from (1,27⫾0,05 to 1,40⫾0,070)sec⫺1 without LVMMI change. The LM lead up to middle-diurnal, middle daily and middle-night BP meaning, their variability decreasing without growth morning dependence from LWMMI dynamics and from initial BPDRT.The diurnal index was decreased (p⬍0,01) in “non-dipper” pts (p⬎0,05) and don’t change significantly in “dipper” pts (p⬎0,05).During repeat investigation the “dipper” type was in 20 pts,“ non-dipper” – in 3 pts. Conclusion: in EH pts the long-term L intake contribute BPDRT normalization in “non-dipper” majority pts and hasn’t influence in “dipper” pts upon its character. The LVMMI important decrease was only in pts with initial LV hypertrophy. The LV regression character depended on initial LV remodelling type. The L treatment con tribute LV contractility increase without LVMMI dynamics dependence. Key Words: Blood Pressure Diurnal Rhythm, Left Ventricular Myocardial Mass, Lisinopril

P-52 BLOOD PRESSURE MORNING SURGE AND DAYTIME BP VARIABILITY AND TARGET ORGAN DAMAGE IN NORMOTENSIVES, HYPERTENSIVES AND DIABETICS Cristina Amaral, Loide Barbosa, Susana Bertoquini, Joao Maldonado, Jose A Silva, Jorge Polo´ nia. Unidade Farmacologia Clinica, Faculdade Medicina Porto, Porto, Portugal; Unidade Hipertensao Risco CV, Hospoital Pedro Hispano, Matosinhos, Portugal. Blood pressure morning surge (BP-MS) and daytime BP variability (daytime BP-VAR) have been associated with target organ damage and