Grossman E, Alster Y, Shemesh J, Nussinovitch N, Rosenthal T
Chorley Hypertension Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Hum Hypertens. 1994 Oct;8(10):741-6.
The purpose of this work was to assess the best haemodynamic determinant of left ventricular hypertrophy (LVH) in patients with essential hypertension. We studied the relationships between left ventricular mass (LVM) and casual, exercise and 24h ambulatory blood pressure monitoring (ABPM) in 60 newly discovered patients with mild to moderate essential hypertension. LVM was only weakly related to both casual and exercise blood pressure, while it was significantly related to average ABPM values. Diastolic hypertensive load, calculated as the percentage of diastolic measurements > 90 mmHg, was the best predictor of the development of LVH (r = 0.51, P < 0.001). Six of six patients with a diastolic load > 50% had LVH, whereas only two of 18 patients (11%) with a diastolic load < 10% had LVH (P < 0.001). In conclusion, in patients with mild to moderate essential hypertension, LVM is poorly related to both casual and exercise blood pressure, but is related to ABPM. Blood pressure load is the best determinant of LVH. These findings suggest that blood pressure load should be considered when analysing ABPM.
这项研究的目的是评估原发性高血压患者左心室肥厚（LVH）的最佳血流动力学决定因素。我们研究了60例新发现的轻至中度原发性高血压患者的左心室质量（LVM）与偶测血压、运动血压及24小时动态血压监测（ABPM）之间的关系。LVM与偶测血压和运动血压仅呈弱相关，而与ABPM的平均值显著相关。以舒张压测量值>90 mmHg的百分比计算的舒张压高血压负荷是LVH发生的最佳预测指标（r = 0.51，P < 0.001）。舒张压负荷>50%的6例患者均有LVH，而舒张压负荷<10%的18例患者中仅有2例（11%）有LVH（P < 0.001）。总之，在轻至中度原发性高血压患者中，LVM与偶测血压和运动血压相关性较差，但与ABPM相关。血压负荷是LVH的最佳决定因素。这些发现提示，在分析ABPM时应考虑血压负荷。
