[OP.6B.01] TWENTY-FOUR HOUR BLOOD PRESSURE PROFILE AND LEFT VENTRICULAR HYPERTROPHY IN HYPERTENSIVE PATIENTS WITH PRIMARY ALDOSTERONISM. (September 2017)

• Record Type: Journal Article
• Authors: Xu, J.; Li, M.; Tang, X.; Zhu, L.; Gao, P.; Wang, J.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523126.09041.d9
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: A higher prevalence of left ventricular hypertrophy (LVH) has been reported in patients with primary aldosteronism (PA) than in blood pressure (BP) level similar patients with essential hypertensive (EH). However, the evidence is limited by lack of diurnal BP pattern. The aim of our study was to evaluate the relationship between 24-hour BP profile and LVH in subjects with PA compare to those patients with EH. Design and method: We studied 385 consecutive patients with PA diagnosed in our hypertension unit from 2010 to 2014 and 385 patients with EH individually matched for age, gender, body mass index (BMI), blood pressure values and duration of hypertension. 24-hour ambulatory BP monitoring (ABPM) and echocardiographic left ventricular mass index (LVMI) were assessed. Results: Two groups were similar in age, gender, BMI, clinic BP, 24-hour BP, daytime BP and duration of hypertension. However, night-time systolic BP (130 ± 16 vs 127 ± 17 mmHg, p < 0.05) and night-time diastolic BP (82 ± 10 vs 79 ± 11 mmHg, p < 0.01) were higher in PA compared with EH group. We found a significantly attenuated nocturnal systolic BP decline (5.6 ± 8.0% vs 8.3 ± 7.7%, p < 0.001) and nocturnal diastolic BP decline in the PA group (6.3 ± 7.9% vs 9.5 ± 8.1%, p < 0.001). Higher log-NT-proBNP levels (1.74 ± 0.41 vs 1.50 ± 0.46, P < 0.001) and LVMI (113 ± 25 vs 102 ± 26 g/m 2, P < 0.001) were found in PA compared with EH patients. The prevalence of non-dippers (51.2% vs 40.8%, p < 0.05) and reverse dippers (19.7% vs 12.5%, p < 0.05)were significantly higher in PA group compared with the EH group. In stepwise multivariate regression analysis, LVMI correlated with night-time systolic BP (β = 0.517, p < 0.001), log-NT-proBNP (β = 16.525, p < 0.001), male sex (β = 11.797, p < 0.001) and age (β = 0.161, p < 0.05). Conclusions: In this study, patients with PA show higher night-time BP levels, but attenuated nocturnal BP decline than those with EH. Higher nocturnal SBP was more closely related to left ventricular hypertrophy in PA patients.