Morning Surge In Blood Pressure,Left Ventricular Hypertrophy And Arrhythmia

Object: to discuss the relationship among the morning surge in blood pressure,left ventricular hypertrophy and arrhythmia.Methods:the essensional hypertension patients were divided into morning surge group (≥55mmHg MS group)and non-morning surge(NMS)group(<55mmHg NMS group) by the results of 24-hour ambulatory Bp monitoring(ABPM)criteria. MS was caculated as follows:mean systolic Bp(SBP) during the 2 hours after awaking minus mean SBP during 1 hour that included the lowest sleep SBP. Left ventricular mass index(LVMI) were calculated by echosardiograph,All patients perform 24-hour continuous ambulatory electrocard- iographic (Holter),through which arrhythmia can be monitored. Finally ,the relationship among them was analyzed.Result: All 102 patients completed the study, LVH was detected in 37 patients, the percent was about 36.3%. Incidence of LVH in the MS group was significantly higher than the NMS group (46% versus 25% P=0.026). the occurrence of arrhythmias was more in the MS groups than the other(22.2% versus 8.3%, P=0.044);when all patients were divided into two groups according LVMI (male>134g/m2, female>110g/m2) the incidence of arrhythmia in the LVH group was significantly higher than the NLVH group(32.4% versus 6.1%, P=0.0005)Conclusion: LVH was prevalence in hypertensive patients without effectively treated, especially in those who have a steep surge in morning blood pressure(MS). There is relationship between MS and LVH. LVH as a predictor of target organ damage, was strongly associated with ventricular arrhythmia. The early morning increase in bp has also been linked to occurrence of arrhythmia. Reduction of the MS could thus be a new therapeutic target for preventing target organ damages and subsequent cardiovascular events in hypertensive patients.