INDEPENDENT ASSOCIATION BETWEEN DIASTOLIC BLOOD PRESSURE VARIABILITY AND LEFT VENTRICULAR MASS INDEX IN RELATIVELY YOUNGER HYPERTENSIVE MEN AND WOMEN

Abstract

Objective: The impact of blood pressure (BP) variability on left ventricular hypertrophy (LVH) remains uncertain and furthermore, its gender differences have not been elucidated. We investigated whether BP variability, assessed by 24-hour ambulatory blood pressure monitoring (24-h ABPM) is independently associated with LV mass index (LVMI) in essential hypertensive men and women.

Design and method: A total of 526 hypertensive patients (mean age 54.5 ± 13.6 years, 292 men and 234 women) who underwent echocardiography were enrolled. LVM was measured by M-mode echocardiography using Devereux's formula and calculated as LVM (g)/height (m) 2.7 (LVMI).

Results: Compared to men, women were older and had lower hemoglobin (Hb) levels, higher LVMI, 24-h systolic BP (SBP) and diastolic BP (DBP) variability values (all p < 0.05). In multivariate analysis, body mass index (BMI) (β = 0.248, p = 0.001), 24-h heart rate (HR) (β = −0.266, p = 0.001), night-time SBP (β = 0.162, p = 0.027), 24-h DBP variability (β = 0.179, p = 0.021) were associated with LVMI in men. On the other hand, in women, age (β = 0.168, p = 0.002), BMI (β = 0.499, p < 0.0001), Hb (β = −0.222, p < 0.0001) and night-time DBP variability (β = 0.161, p = 0.003) were found to be independent determinants of LVMI.

Conclusions: Among essential hypertensive patients, DBP variability was associated with LVMI independent of 24-h ABP levels in both men and women. However, in men, night-time SBP and 24-h HR were also independently related to LVMI, and the effect of age and Hb level on LVMI were greater in women than in men.