Open AccessMorning Hypertension Assessed by Home Monitoring Is a Strong Predictor of Concentric Left Ventricular Hypertrophy in Patients With Untreated Hypertension
Author(s) -
Matsui Yoshio,
Eguchi Kazuo,
Shibasaki Seiichi,
Ishikawa Joji,
Shimada Kazuyuki,
Kario Kazuomi
Publication year - 2010
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2010.00350.x
Subject(s) - medicine , morning , cardiology , left ventricular hypertrophy , evening , concentric hypertrophy , blood pressure , odds ratio , concentric , confidence interval , muscle hypertrophy , confounding , geometry , physics , mathematics , astronomy
J Clin Hypertens (Greenwich). 2010;12:776‐783. © 2010 Wiley Periodicals, Inc. This study was performed to test whether morning hypertension defined by the morning‐evening difference in home blood pressure (BP) (MEdif) and the average of morning and evening BP (MEave) is a determinant of concentric left ventricular hypertrophy (LVH). The authors enrolled patients with untreated hypertension and performed echocardiography and home BP monitoring for 14 consecutive days. All patients were classified into 4 groups by the MEave and MEdif and morning hypertension was defined by MEave ≥135 mm Hg and MEdif ≥15 mm Hg. Left ventricular (LV) geometry was classified as normal, concentric remodeling, eccentric LVH, or concentric LVH. The morning hypertensive patients had a higher LV mass index and relative wall thickness than the other groups. According to multivariable logistic regression analysis, morning hypertensive patients had a significantly increased risk of the concentric LVH (odds ratio, 6.5; 95% confidence interval, 2.5–17.2; P <.001) compared with home normotensive patients with MEdif <15 mm Hg, after adjusting for confounders. Moreover, even among the home normotensives (white‐coat hypertensives), patients with MEdif ≥15 mm Hg had a higher percentage of concentric remodeling than those with MEdif <15 mm Hg (32.5% vs 14.7%, P =.017). Morning hypertension defined by the MEdif and MEave is a strong determinant of concentric LVH, suggesting that this definition could be used to determine the cardiovascular risk of morning hypertension.