Stress-induced blood pressure measurements predict left ventricular mass over three years among borderline hypertensive men

被引:48
作者
Georgiades, A
Lemne, C
DeFaire, U
Lindvall, K
Fredrikson, M
机构
[1] UPPSALA UNIV,DEPT CLIN PSYCHOL,UPPSALA,SWEDEN
[2] KAROLINSKA INST,INST ENVIRONM MED,DIV CARDIOVASC EPIDEMIOL,S-10401 STOCKHOLM,SWEDEN
[3] KAROLINSKA HOSP,DEPT MED,DIV CARDIOVASC MED,S-10401 STOCKHOLM,SWEDEN
关键词
blood pressure; borderline hypertension; left ventricular mass; reactivity; stress;
D O I
10.1046/j.1365-2362.1997.1800729.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Exaggerated cardiovascular reactivity has been implicated in the development of left ventricular hypertrophy. The aim of the present study was to investigate the predictive value of casual clinic, 24-h ambulatory blood pressure and stress-induced blood pressure measurements in the laboratory for left ventricular structures over a 3-year period in a group of middle-aged borderline hypertensive men. The stress test included a pretask resting period and two tasks, mental arithmetic and isometric muscle contraction. Left ventricular wall thickness was assessed by M-mode echocardiography. All stress-induced blood pressure levels and reactivity measures as well as ambulatory systolic blood pressure and mean arterial pressure levels were significantly correlated with left ventricular mass index (LVMI) 3 years later (r = 0.31-050), whereas there were no significant correlations between casual clinic or resting BP measurement and LVMI. A stepwise multiple regression analysis with LVMI at the 3-year follow-up as the dependent variable was applied. Baseline LVMI was entered as a forced variable and explained 24% of the variance in LVMI. Mean arterial blood pressure reactivity in the laboratory was the strongest additional independent variable, and added 15% to the prediction of LVMI 3 years later. Using a median split approach, the borderline hypertensive group was divided into high and low BP reactors. High and low BP reactors did not differ at initial baseline, but at the 3-year follow-up the high reactive group had significantly larger LVMI than the low reactive group. Results from the present study suggest that stress-induced BP reactivity measurements predict the development of LVMI better than casual or resting BP measurements. Thus, measuring BP during standardized stress tests could be a method used to identify borderline hypertensive individuals at increased risk of developing left ventricular hypertrophy.
引用
收藏
页码:733 / 739
页数:7
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