Morning Rise in Blood Pressure Is a Predictor of Left Ventricular Hypertrophy in Treated Hypertensive Patients

Abstract

To assess the relationship between home blood pressure and left ventricular mass, we evaluated cardiac echocardiography in 297 hypertensive subjects (188 men and 109 women; mean age, 62.8±10.3 years) who were treated with amlodipine monotherapy over 1 year (mean dose, 5.5±2.3 mg/day). The morning hypertension group (n =57; 19.2%), who had a morning home systolic blood pressure (HSBP) ≥135 mmHg and an evening HSBP n =174; 58.6%), whose morning and evening HSBP were both n =63; 21.2%), whose morning and evening HSBP were both ≥135 mmHg. By grouping of subjects according to the difference between morning and evening HSBP (ΔHSBP), subjects with a ΔHSBP≥10 mmHg had a significantly greater LVMI than subjects with a ΔHSBP r² =36.2%, p r² =5.5%, p r² =1.4%, p =0.016) and age (r² =1.0%, p =0.026) were determined to be significant contributing factors for LVMI. This regression model could explain 44.1% of LVMI variability. These results suggest that morning rise in blood pressure is a dominant predictor of left ventricular hypertrophy. (Hypertens Res 2004; 27: 939-946)