Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Sacchi N, Battistelli M, Guerrieri M, Comparato E, Porcellati C
Unità Organica di Malattie Cardiovascolari e Medicina Interna, Ospedale Generale Regionale R. Silvestrini, Perugia, Italy.
Am J Hypertens. 1995 Feb;8(2):193-6. doi: 10.1016/0895-7061(94)00187-G.
The finding of increased left ventricular (LV) mass in hypertensive subjects with blunted nocturnal fall in blood pressure (BP) might be an artifact of matching patients for daytime BP, with resulting higher 24-h BP in nondippers. Therefore, we compared a large number (n = 1048) of hypertensive dippers and nondippers in their LV mass at echocardiography before and after adjustment for 24-h, daytime, and nighttime ambulatory BP. In men, the difference between dippers and nondippers was not significant before and after adjustment for 24-h BP, but after adjustment for nighttime BP LV mass was greater in dippers (more properly "peakers"). In women, LV mass was greater in nondippers than in dippers both before and after adjustment for 24-h BP, while the difference between the two groups disappeared after adjustment for nighttime BP. Thus, for any given level of mean 24-h BP, a flattened diurnal BP profile is associated with a greater LV mass in hypertensive women. Daytime hypertension, either associated or not with a blunted nocturnal fall in BP, may be a sufficient determinant of LV wall thickening in men.
在夜间血压（BP）下降不明显的高血压患者中发现左心室（LV）质量增加，可能是在匹配患者日间血压时产生的假象，导致非勺型血压者24小时血压更高。因此，我们比较了大量（n = 1048）高血压勺型血压者和非勺型血压者在经24小时、日间和夜间动态血压调整前后的超声心动图左心室质量。在男性中，经24小时血压调整前后，勺型血压者和非勺型血压者之间的差异不显著，但经夜间血压调整后，勺型血压者（更确切地说是“峰型血压者”）的左心室质量更大。在女性中，经24小时血压调整前后，非勺型血压者的左心室质量均大于勺型血压者，而经夜间血压调整后，两组之间的差异消失。因此，对于任何给定水平的24小时平均血压，高血压女性中昼夜血压曲线变平与更大的左心室质量相关。无论是否与夜间血压下降不明显相关，日间高血压可能是男性左心室壁增厚的充分决定因素。
