Relation of ambulatory blood pressure load with left ventricular geometry in untreated patients with mild-to-moderate hypertension.

Whether ambulatory blood pressure (ABP) load is associated with left ventricular (LV) geometry was assessed in 335 patients (range 32-72 years) with stage I-II essential hypertension by performing 24-h ABP monitoring and echocardiographic examination. Of these 335 hypertensive subjects, 116 (34.5%) had normal LV geometry, 136 (40.5%) had concentric LV remodelling, 37 (11%) had eccentric LV hypertrophy and 46 (14%) had concentric LV hypertrophy according to the relative wall thickness and left ventricular mass index. Subjects with concentric LV hypertrophy had significantly increased 24-h systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure as well as increased 24-h SBP and DBP load compared to those with normal LV geometry or concentric LV remodelling while there was no difference in the above parameters in comparison with the subjects with eccentric LV hypertrophy. The incidence of patients with normal LV geometry was significantly decreasing and the incidence of patients with LV-CH was significantly increasing as the degree of ABP loads were increasing. Using multiple regression analysis models with each type of LV geometry as a dependent variable and various degree of ABP loads as independent variables, it was revealed that normal LV geometry was significantly related with normal values of 24-h SBP and DBP load (P < 0.05) while there was not any significant relation between concentric LV remodelling and 24-h SBP or DBP load values. Concentric LV hypertrophy was significantly related with increased values of both 24-h SBP and DBP load (P < 0.05) while eccentric LV hypertrophy was significantly related with increased values of 24-h DBP load only (P < 0.05). In conclusion normal LV geometry is associated with normal values of SBP and DBP load while concentric LV hypertrophy is associated with increased values of both SBP and DBP load.