A Study On The Relationship Between 24-hour Ambulatory Blood Pressure And Left Ventricular Hypertrophy In Essential Hypertension Patients

Objective: Objective to investigate the correlation between 24-hour ambulatory blood pressure and left ventricular hypertrophy in patients with essential hypertension,and to observe the relationship between ambulatory blood pressure and left ventricular geometry.Methods: Collected from January to September 2016,224 cases with essential hypertension were diagnosed in the Department of Cardiology of our hospital,including 89 males and 135 females.According to the left ventricular mass index(LVMI),patients with hypertension were divided into hypertrophy group(n=95)and non-hypertrophy group(n=129).The general clinical data and 24 h ambulatory blood pressure were compared between the two groups,and the relationship between ambulatory blood pressure data and left ventricular hypertrophy was analyzed.The hypertensive patients were divided into 4 groups according to the left ventricular geometry: normal geometry,concentric remodeling,concentric hypertrophy,eccentric hypertrophy.The indexes of the 4 groups of ambulatory blood pressure were analyzed by variance analysis,and the relationship between the ambulatory blood pressure index and the left ventricular mass and the relative ventricular wall thickness was discussed.Results:(1)There was significant difference in age and sex between hypertrophy group and non-hypertrophy group(p<0.05);(2)There were significant differences in the systolic blood pressure,daytime systolic pressure,daytime systolic pressure and night systolic pressure in the hypertrophy and non-hypertrophy groups(p<0.05);(3)The results of variance analysis in 4 subgroups of normal geometry group,concentric remodeling group,concentric hypertrophy group,eccentric hypertrophy group showed that morning peak SBP,24 h mean SBP,daytime mean SBP,night mean SBP,24 h SBP load value,daytime SBP load value,night SBP load value,and night DBP blood pressure variability were statistically significant(P<0.05);The results showed that there were significant differences between morning peak SBP,daytime SBP,daytime SBP load and 24 h SBP(P<0.05).There was no statistical difference between the group 0(normal geometry group)and group 1(concentric remodeling group),group 2(eccentric hypertrophy group)and group 3(concentric hypertrophy group)(P > 0.05);group 0(normal geometry group)and group 2(eccentric hypertrophy group)、 group 0(normal geometry group)and group 3(concentric hypertrophy group),group 1(concentric remodeling group)and group 2(eccentric hypertrophy group),group 1(concentric remodeling group)and group 3(concentric hypertrophy group)have statistically significant difference(P < 0.05).(4)single factor logistic regression analysis was used to analyze LVH related factors,and binary multivariate logistic regression analysis was used to analyze factors with statistically significant differences in analysis results;(5)Multivariate Logistic regression analysis showed that gender(OR=2.179,P=0.021)and daily systolic blood pressure(OR=1.085,P=0.010)were associated with the occurrence of LVH.Conclusion: 1、The occurrence of LVH in patients with essential hypertension is closely related to the daily systolic blood pressure load,and the incidence of women is higher than that of men;2、With the increase of morning peak SBP,daytime mean SBP,daytime SBP load(%)and 24 h mean SBP can cause left ventricular hypertrophy,and with the increase of these indicators,the left ventricular mass is more likely to increase,rather than the thickening of the wall.