Prevalence of target organ damage in treated hypertensive patientsdifferent impact of clinic and ambulatory blood pressure control
作者:
Cesare Cuspidi,
Laura Lonati,
Lorena Sampieri,
Iassen Michev,
Giuseppe Macca,
José Rocanova,
Maurizio Salerno,
Veronica Fusi,
Gastone Leonetti,
Alberto Zanchetti,
期刊:
Journal of Hypertension
(OVID Available online 2000)
卷期:
Volume 18,
issue 6
页码: 803-809
ISSN:0263-6352
年代: 2000
出版商: OVID
关键词: clinic and ambulatory blood pressure control;hypertension;left ventricular hypertrophy;microalbuminuria
数据来源: OVID
摘要:
ObjectivesFirst, to evaluate the prevalence of left ventricular (LV) hypertrophy, LV concentric remodelling and microalbuminuria in a selected sample of treated hypertensive patients with effective and prolonged clinic blood pressure (BP) control (BP <140/90 mmHg). Second, to compare the prevalence of these markers of organ damage in patients with and without ambulatory BP (ABP) control, defined as average daytime BP <132/85 mmHg).Design and methodsFifty-eight consecutive hypertensive patients who attended our hypertension outpatient clinic over a period of 3 months and were regularly followed up by the same medical team were included in the study. Obesity, diabetes mellitus, history or signs of cardiovascular or renal complications and major noncardiovascular diseases were the exclusion criteria from the study. Each patient underwent 24 h ABP monitoring, echocardiography and 24 h urine collection for albumin measurement.ResultsThe prevalence of LV hypertrophy (LV mass index >125 g/m2in both sexes), LV concentric remodelling (relative wall thickness >0.45) and microalbuminuria (urinary albumin excretion <300 mg/ 24 h) in this selected group of patients (32 men, 26 women; mean age 53 ± 9 years; mean clinic BP 122 ± 9/78 ± 6 mmHg) was markedly low (6.9, 8.6 and 5.1%, respectively).The 26 patients with effective ABP control (group I) were similar to the 32 patients without effective ABP control (group II) in age, gender, body surface area, clinic BP, smoking habit, glucose, cholesterol and creatinine plasma levels.Prevalence of LV hypertrophy, LV concentric remodelling and microalbuminuria was lower in group I than in group II (0 versus 12.9%P<0.01, 7.7 versus 9.4% NS, 3.8 versus 6.2% NS, respectively).ConclusionsThis study demonstrates that nonobese, nondiabetic hypertensive patients with an effective clinic BP control have a very low prevalence of target organ damage and that LVH is present only in individuals with insufficient ABP control.
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