Not nondipping but nocturnal blood pressure predicts left ventricular hypertrophy in the essential hypertensive patients: The Korean Ambulatory Blood Pressuremulticenter observational study

Jeong Eun Yi, Jinho Shin, Sang Hyun Ihm, Ju Han Kim, Sungha Park, Kwang Il Kim, Woo Shik Kim, Wook Bum Pyun, Yu Mi Kim, Soon Kil Kim

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: The aim of this study was to investigate whether nocturnal blood pressure (BP), established on the basis of a single 24-h BP monitoring, is a stronger predictor of left ventricular hypertrophy (LVH) compared with nondipping status in the essential hypertensive patients. Methods: A total of 682 hypertensive patients (mean age 56.1±14.5 years, 50.7% women) who underwent echocardiography were enrolled. 'Nondipping status' was defined as a nocturnal SBP fall less than 10% of daytime mean SBP. LVH was defined as a left ventricular mass index exceeding 54.0 g/m2.7 in men and 53.0 g/m2.7 in women. Each patient was categorized in three groups according to the total cardiovascular risk using 2007 European Society of Hypertension/ European Society of Cardiology guidelines as average or low, moderate, and high or very high added risk. Results: Among 682 participants, 184 (26.9%) showed LVH on echocardiography. The proportion of individuals with high or very high added cardiovascular risk profile was 356 (52.1%). In multiple logistic regression analysis, age 56 years at least [odds ratio (OR) 1.047, 95% confidence interval (CI) 1.031-1.063, P<0.0001], female participants (OR 1.751, 95% CI 1.172-2.616, P=0.0062), BMI higher than 24.6 kg/m2 (OR 1.178, 95% CI 1.110- 1.250, P<0.0001), smoking (OR 1.793, 95% CI 1.028- 3.127, P=0.0397), and nocturnal SBP at least 127mmHg (OR 1.032, 95% CI 1.009-1.055, P=0.0059) were significant independent predictors for LVH whereas nondipping was not (OR 0.857, 95% CI 0.481-1.528, P=0.6013). Conclusion: These findings suggest that nocturnal BP rather than nondipping may be a better predictor of LVH, especially in secondary or tertiary referral hospital setting targeting relatively high cardiovascular risk patients.

Original languageEnglish
Pages (from-to)1999-2004
Number of pages6
JournalJournal of Hypertension
Volume32
Issue number10
DOIs
Publication statusPublished - 2014 Oct 1

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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