[The relationship between ambulatory blood pressure and left ventricular hypertrophy in essential hypertension].

The relationship between ambulatory blood pressure (ABP) and left ventricular hypertrophy (LVH) were investigated in 137 consecutive subjects (54 healthy normotensives and 83 uncomplicated patients with essential hypertension) who underwent 24-hour noninvasive ABP monitoring and M-mode echocardiography. In the normotensive group, left ventricular mass index (LVMI) was not correlated with average daytime (6AM-10PM) or nighttime (10PM-6AM) systolic and diastolic blood pressure (SBP and DBP) except for age (r = 0.405, P < 0.01). In the hypertensive group, however, LVMIs were significantly correlated with average daytime SBP (r = 0.315, P < 0.01), nighttime SBP (r = 0.408, P < 0.01) and DBP (r = 0.304, P < 0.01). Furthermore, significant inverse correlations were found between LVMI and percentage of nocturnal reduction of daytime SBP (r = -0.393, P < 0.01) and DBP (r = -0.308, P < 0.01). The results suggest that the average levels of ABP, particularly, the level of ABP during night and the loss of circadian variation of blood pressure, would be responsible for the development of LVH. The control of blood pressure and restoration of circadian blood pressure variation might be necessary for the reversal of LVH in hypertensive patients.