Predicting hypertensive heart disease via non-invasive methodology: relationship between ambulatory blood pressure and cardiac indices derived by echocardiography and radionuclide ventriculography

Abstract

The sensitivity of echocardiographically derived left ventricular mass in predicting morbidity in essential hypertension has led to widespread use of this measurement in cross-sectional studies to assess the pathophysiology of hypertensive heart disease. Over the past decade, a variety of studies in hypertensives have evaluated the blood pressure determinants of both the structural and the functional aspects of left ventricular hypertrophy. Recent data presented here demonstrate that average daily blood pressure derived from non-invasive ambulatory blood pressure monitoring is superior to casual blood pressure in predicting an increased left ventricular mass index and left atrial dimension, and altered left ventricular systolic and diastolic function. Further data analysis in previously untreated mildly hypertensive subjects (diastolic blood pressure less than 140/90 mmHg) showed that the average daily pressure load (defined as the percentage of blood pressure values greater than 140/90 mmHg while awake and greater than 120/80 mmHg during sleep) delineates groups at high and low risk of developing hypertensive heart disease.