Correlation Between Ambulatory Blood Pressure Monitoring and Left Ventricular Hypertrophy

Abstract

Background: Left ventricular hypertrophy (LVH) is an important manifestation of hypertension-mediated organ damage and is associated with increased cardiovascular morbidity and mortality. Ambulatory blood pressure monitoring (ABPM) provides a more comprehensive assessment of blood pressure than office measurements and may better predict cardiac target-organ damage.

Methods: This hospital-based observational cross-sectional study included 90 adult patients with systemic hypertension. All participants underwent 24-hour ABPM and transthoracic echocardiography. Ambulatory blood pressure parameters were compared between patients with and without LVH. Correlation analysis was performed between ABPM indices and left ventricular mass index (LVMI), and multivariable logistic regression was used to identify independent predictors of LVH.

Results: LVH was present in 46 (51.1%) patients. Individuals with LVH had significantly higher 24-hour, daytime and nighttime systolic blood pressure (SBP), pulse pressure and blood pressure load than those without LVH (all p<0.05). Nighttime SBP showed the strongest correlation with LVMI (r=0.76, p<0.001). Multivariable analysis identified nighttime SBP ≥130 mmHg (adjusted OR 4.26, 95% CI 1.82–9.96), non-dipping blood pressure pattern (adjusted OR 3.18, 95% CI 1.37–7.36), 24-hour SBP ≥140 mmHg (adjusted OR 2.91, 95% CI 1.24–6.83), and hypertension duration >10 years (adjusted OR 2.64, 95% CI 1.10–6.31) as independent predictors of LVH.

Conclusion: ABPM-derived parameters, particularly nighttime SBP and abnormal nocturnal dipping, demonstrated a strong association with LVH and were superior to office blood pressure measurements in identifying hypertension-mediated cardiac damage. Routine use of ABPM may improve cardiovascular risk stratification and facilitate earlier intervention in patients with systemic hypertension.